Single and double mucosal microflap CO2 laser “sliding” technique in the management of iatrogenic glottic web: anatomical and functional results

Background. Otosclerosis is a progressive osteo-destructive disorder of the bony labyrinth in which the fixation of the stapes causes the hearing loss. The aim of this study was the postoperative determination of parameters of the effect of surgical intervention on hearing and the incidence of complications and, on the basis of the differences in the examined parameters of the study, the estimation of the eficacy of the two mentioned surgical thechniques in the treatment of otosclerosis. Methods. In our research 40 patients with conductive hearing loss caused by otosclerosis underwent surgery with CO2 laser. Functional results were compared postoperatively with the results of 40 patients operated by the classical technique without the use of CO2 laser. The research was accomplished as a prospective comparative study. Results. The air-bone interval (gap) as the difference between the rim of air and bone conductivity for separate frequencies did not significantly differ between the control and the experimental group. Both methods were effective in closing the air-bone gap with the rates of closure to within 10 dB in 82.6% and 75.3% for the laser and drill, respectively. The incidence of tinnitus was significantly lower in patients who underwent surgery with CO2 laser. The frequency of intraoperative and postoperative complications was significantly lower in the laser group. Differences were statistically significant for all parameters (p<0.05). Conclusion. On the basis of the degree of postoperative hearing improvement, tinnitus and the incidence of complications it can be concluded that the use of CO2 laser during inverse stapedoplasty represents an effective and safe method, justifying the promotion of its use in the surgical management of otosclerosis.

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Long-term functional results after endoscopic cricopharyngeal myotomy with CO2 laser: a retrospective study of 32 cases

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-012-2214-1 ◽

2012 ◽

Vol 270 (3) ◽

pp. 965-968 ◽

Cited By ~ 10

Author(s):

Vincent Bachy ◽

Nayla Matar ◽

Marc Remacle ◽

Jacques Jamart ◽

Georges Lawson

Keyword(s):

Retrospective Study ◽

Co2 Laser ◽

Functional Results ◽

Cricopharyngeal Myotomy

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C02 Laser-assisted Phonosurgery for Benign Glottic Lesions

Otolaryngology ◽

10.1016/j.otohns.2008.05.157 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P48-P48

Author(s):

Marcel Geyer ◽

Gian-Peppino Ledda ◽

Neil C Tan ◽

Roberto Puxeddu Consultant

Keyword(s):

Co2 Laser ◽

Vocal Fold ◽

Voice Quality ◽

Case Series ◽

Functional Results ◽

Disease Recurrence ◽

Wilcoxon Test ◽

Control Group ◽

Retrospective Case ◽

False Vocal

Objective (1) To determine glottic function following carbon dioxide (CO2) laser-assisted phonosurgery of benign laryngeal disease. (2) To evaluate post-operative glottic morphology and disease recurrence rate. Methods Comparative retrospective case series of patients with benign glottic pathology treated by laser-assisted phonosurgery over 10 years. 235 consecutive patients had pre- and postoperative data collected from objective laryngeal examination, videostroboscopy recording of vocal fold mucosal wave movement, electroacoustic voice analysis of fundamental frequency, jitter, shimmer, and harmonics to noise ratio, as well as perceptual voice evaluation. This data was also compared to that of 20 healthy volunteers. (Statistical analysis: Wilcoxon test and Mann-Whitney test respectively). Definitive voice and morphologic evaluation was completed after 6 months. Results Evaluation of the pre- and postoperative functional results demonstrated a statistically significant improvement in all spectrographically analysed objective voice parameters (p<0.001), with a restored voice quality as good as the control group (p<0.001). Postoperative morphological analysis using videostroboscopic examination confirmed 3 recurrences of granuloma and 1 of Reinke's oedema. Recurrence was estimated objectively if the lesion was analogous to the original pathology. Glottic closure was complete in 96.5% of cases. False vocal fold adduction was normal in 88.5% of cases, with forced hyper-adduction being present in 11.5%. Phonatory vibration was cord-cord type in 100% of cases. Conclusions Our study demonstrates a statistically significant improvement in all acoustic parameters recorded. Postoperative vocal fold function and mucosal wave morphology were largely restored. CO2 laser-assisted voice restoration for benign glottic disease is effective.

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Surgical Therapy of T1 and Selected Cases of T2 Glottic Carcinoma: Cordectomy, Horizontal Glottectomy and CO2 Laser Endoscopic Resection

Tumori Journal ◽

10.1177/030089160008600403 ◽

2000 ◽

Vol 86 (4) ◽

pp. 277-282 ◽

Cited By ~ 15

Author(s):

Roberto Puxeddu ◽

Federico Argiolas ◽

Steven Bielamowicz ◽

Maddalena Satta ◽

Gian Peppino Ledda ◽

...

Keyword(s):

Local Recurrence ◽

Co2 Laser ◽

Local Control ◽

Salvage Surgery ◽

Anterior Commissure ◽

Functional Results ◽

Cumulative Probability ◽

Glottic Carcinoma ◽

Primary Surgery ◽

Endoscopic Laser

Aims and background Among the different laryngeal neoplasms, glottic carcinoma is known to be one of the most suitable for functional management. Nevertheless, the best treatment for T1 and T2 glottic carcinoma, whether an open neck procedure, endoscopy or radiotherapy, with reference to recurrence, survival, and functional results, has long been debated. Study design From February 1983 to September 1997, 83 patients with well to undifferentiated glottic carcinoma (48 pT1a, 14 pT1b, and 21 selected cases of pT2 with impairment of vocal cord mobility) were submitted to surgery at the Otorhinolaryngologic Section of the Department of Surgical Sciences and Organ Transplantations of Cagliari University. Surgical treatment included 30 laryngofissures with simple or enlarged cordectomy, 22 horizontal glottectomies and 31 endoscopic laser resections. A retrospective review of the records of the patients was performed in order to obtain a better understanding of the outcome of the three different surgical procedures in our institution. Results According to the Kaplan-Meier method, the probability of remaining free of local recurrence 3 years after primary surgery was 0.90 for the T1 group and 0.85 for the T2 group. The distribution of recurrences for cordectomy, glottectomy and CO2 laser at 3 years showed a cumulative probability of remaining free of disease after primary surgery of 0.86, 0.85 and 0.88. The probability of remaining free of local recurrence 3 years after salvage surgery was 0.96 for the T1 group and 0.95 for the T2 group. Analyzing the phenomena for type of surgical procedure, local control at 3 years after salvage surgery for cordectomy, glottectomy and exclusive CO2 laser was 0.93, 0.90 and 0.92, respectively. In the endoscopic group, local control rate after any type of salvage therapy modified the percentage at 3 years to 100%. Anterior commissure spread (AC1-AC2) resulted in a difference (not statistically significant) in local control between the group of patients without and with anterior commissure involvement. Laryngeal preservation was achieved in 93.7% (45/48) of patients who survived after salvage surgery following open neck procedures and in 100% of patients originally submitted to the endoscopic approach. Conclusions In our experience, although open laryngeal procedures can be still considered a valid option in the treatment of T1 and selected cases of T2 glottic carcinoma, endoscopic laser excision offered an oncologically adequate alternative to the traditional techniques, with minimum discomfort for the patient and satisfactory preliminary functional results.

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Morphometric and functional results after CO2 laser welding of nerve coaptations

Lasers in Surgery and Medicine ◽

10.1002/1096-9101(2000)27:1<66::aid-lsm9>3.0.co;2-z ◽

2000 ◽

Vol 27 (1) ◽

pp. 66-72 ◽

Cited By ~ 12

Author(s):

Wolfgang Happak ◽

Christoph Neumayer ◽

Gregor Holak ◽

Rafic Kuzbari ◽

Georg Burggasser ◽

...

Keyword(s):

Laser Welding ◽

Co2 Laser ◽

Functional Results

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CO2 laser colposcopic guided surgery for the see and treat management of VHSIL: a preliminary experience

Lasers in Medical Science ◽

10.1007/s10103-021-03413-y ◽

2021 ◽

Author(s):

C. Bianchi ◽

N. Auzzi ◽

I. Turrini ◽

A. De Magnis ◽

M. G. Fallani ◽

...

Keyword(s):

Co2 Laser ◽

Therapeutic Option ◽

Functional Results ◽

University Hospital ◽

Exact Test ◽

Guided Surgery ◽

Relative Risks ◽

Good Cosmetic ◽

Laser Excision

Abstract The purpose of this study is to evaluate the efficiency of CO2 laser colposcopic guided surgery performed in an outpatient see and treat setting in the management of VHSIL. Women with a suspected diagnosis of VHSIL and no vulvoscopic suspicion of vSCC were enrolled. An electronic register of CO2 laser treatment was created where description of performing parameters (excision or ablation) was specified and personal history was recorded. Statistical analysis was performed by Fisher’s exact test. Relative risks (RR) of risk factor were calculated and expressed in odds. From September 2014 to September 2018, we enrolled a total of 63 patients who underwent CO2 laser procedure and had a minimum follow-up time of 2 years at Careggi University Hospital in Florence. Forty-eight (76.2%) patients underwent laser excision and 15 (23.8%) patients underwent ablative treatment without histological results. Undertreatment was performed in 3 cases (6.3%) with definitive histology of vSCC. Therapeutical appropriateness of CO2 laser excision was reached in 85.4% of the cases (41/48). No volunteer loss to follow-up was registered; thus, fidelity to treatment was assess at 100%. Recurrence rate within 2 years attested in 8/60 followed patients (13.3%). No personal factor was found to influence the VHSIL course. CO2 laser excision may represent an excellent therapeutic option to VHSIL because it provides adequate oncological purpose with good cosmetic and functional results and high patients’ loyalty to treatment. An expert team could allow to undergo patients with VHSIL suspicion to unique diagnostic and therapeutic procedure with significant benefits.

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