Intraindividual comparison of 1,470 nm diode laser versus carbon dioxide laser for tonsillotomy

TY - JOUR

T1 - Intraindividual comparison of 1,470 nm diode laser versus carbon dioxide laser for tonsillotomy

T2 - a prospective, randomized, double blind, controlled feasibility trial

AU - Havel, Miriam

AU - Sroka, Ronald

AU - Englert, Elsa

AU - Stelter, Klaus

AU - Leunig, Andreas

AU - Betz, Christian S

N1 - Copyright © 2012 Wiley Periodicals, Inc.

PY - 2012/9

Y1 - 2012/9

N2 - INTRODUCTION: The need for reduction of post-tonsillectomy hemorrhage has led to promotion of tonsillotomy techniques for tonsil tissue reduction in obstructive tonsillar hypertrophy. This trial compares ablative tissue effects using 1,470 nm diode laser and carbon dioxide laser for tonsillotomy in an intraindividual design.METHODS: 21 children aged 3-13 years (mean age 6.3 years) underwent laser tonsillotomy for obstructive tonsillar hypertrophy in this double blind, prospective, randomized, clinical feasibility trial. In each of the blinded patients, tonsillotomy was performed using fiber guided 1,470 nm diode laser (contact mode, 15 W power) on the one side and carbon dioxide laser (12 W power) on the other side. An independent, blinded physician documented clinical presentation and patients' symptoms preoperatively and on Days 1, 3, 7, 14, and 21 post-operatively using standardized questionnaire including VAS for each side separately.RESULTS: The mean duration of operative treatment was 2.7 min using 1,470 nm laser and 4.9 min using carbon dioxide laser respectively. Intraoperative bleeding and the frequency of bipolar forceps use for intraoperative bleeding control was significantly less using 1,470 nm diode laser system. There was no difference in post-operative pain scores between the carbon dioxide laser treated and the 1,470 nm fiber guided diode laser treated side. No infections, hemorrhages or other complications occurred in the course of the 3 weeks post-operative period.CONCLUSIONS: A fiber-guided 1,470 nm diode laser system offers an efficient and safe method for tonsillotomy as treatment of obstructive tonsillar hypertrophy. Compared to our standard practice (carbon dioxide laser), 1,470 nm laser application provides comparable tissue ablation effects with less intraoperative bleeding and shorter operation time.

AB - INTRODUCTION: The need for reduction of post-tonsillectomy hemorrhage has led to promotion of tonsillotomy techniques for tonsil tissue reduction in obstructive tonsillar hypertrophy. This trial compares ablative tissue effects using 1,470 nm diode laser and carbon dioxide laser for tonsillotomy in an intraindividual design.METHODS: 21 children aged 3-13 years (mean age 6.3 years) underwent laser tonsillotomy for obstructive tonsillar hypertrophy in this double blind, prospective, randomized, clinical feasibility trial. In each of the blinded patients, tonsillotomy was performed using fiber guided 1,470 nm diode laser (contact mode, 15 W power) on the one side and carbon dioxide laser (12 W power) on the other side. An independent, blinded physician documented clinical presentation and patients' symptoms preoperatively and on Days 1, 3, 7, 14, and 21 post-operatively using standardized questionnaire including VAS for each side separately.RESULTS: The mean duration of operative treatment was 2.7 min using 1,470 nm laser and 4.9 min using carbon dioxide laser respectively. Intraoperative bleeding and the frequency of bipolar forceps use for intraoperative bleeding control was significantly less using 1,470 nm diode laser system. There was no difference in post-operative pain scores between the carbon dioxide laser treated and the 1,470 nm fiber guided diode laser treated side. No infections, hemorrhages or other complications occurred in the course of the 3 weeks post-operative period.CONCLUSIONS: A fiber-guided 1,470 nm diode laser system offers an efficient and safe method for tonsillotomy as treatment of obstructive tonsillar hypertrophy. Compared to our standard practice (carbon dioxide laser), 1,470 nm laser application provides comparable tissue ablation effects with less intraoperative bleeding and shorter operation time.

KW - Adolescent

KW - Blood Loss, Surgical

KW - Child

KW - Child, Preschool

KW - Double-Blind Method

KW - Feasibility Studies

KW - Humans

KW - Hyperplasia

KW - Lasers, Gas

KW - Lasers, Semiconductor

KW - Operative Time

KW - Pain, Postoperative

KW - Palatine Tonsil

KW - Prospective Studies

KW - Tonsillectomy

KW - Treatment Outcome

KW - Comparative Study

KW - Journal Article

KW - Randomized Controlled Trial

U2 - 10.1002/lsm.22053

DO - 10.1002/lsm.22053

M3 - SCORING: Journal article

C2 - 22837058

VL - 44

SP - 558

EP - 563

JO - LASER SURG MED

JF - LASER SURG MED

SN - 0196-8092

IS - 7

ER -