Anatomic Study of Laser-Assisted Endoscopic Cricopharyngeus Myotomy

Objectives: Laser-assisted endoscopic cricopharyngeus muscle (CPM) myotomy has been used to correct dysphagia caused by CPM dysfunction. The aim of this study was to anatomically characterize this procedure in hopes of demonstrating its safety and efficacy. Methods: A Dohlman endoscope was used to isolate the CPM in 5 lightly preserved, thawed cadavers. A carbon dioxide laser at 10 W continuous power was used to section through the CPM in conjunction with a micromanipulator connected to an operating microscope. The specimens were then carefully dissected and photographed to demonstrate the anatomy of the pharyngoesophageal segment, including the location of the incision and the condition of the tissue planes. The CPM was harvested for histologic studies, sectioned, and prepared with modified Gomori trichrome stain. Results: Gross examination of the retropharyngeal region revealed the presence of intact buccopharyngeal fascia between the lasered region and the retropharyngeal space. Histologic analysis demonstrated sectioning of the CPM with preservation of this fascia layer. Placement of the endoscope was difficult in 1 cadaver, in which we were unable to properly identify the CPM. Conclusions: The carbon dioxide laser-assisted endoscopic CPM myotomy is a potentially anatomically safe and viable procedure when properly performed. However, the potential for violation of the retropharyngeal space is real.

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Use of the Carbon Dioxide Laser for Acoustic Tumor Surgery

Neurosurgery ◽

10.1227/00006123-198303000-00006 ◽

1983 ◽

Vol 12 (3) ◽

pp. 286-290 ◽

Cited By ~ 19

Author(s):

John H. Robertson ◽

Craig W. Clark ◽

James T. Robertson ◽

Gale L. Gardner ◽

Coyle M. Shea

Keyword(s):

Carbon Dioxide ◽

Surgical Technique ◽

Carbon Dioxide Laser ◽

Tumor Surgery ◽

Operating Microscope ◽

Intracranial Surgery ◽

Technical Modifications ◽

Acoustic Tumor ◽

Neurological Surgery ◽

And Control

Abstract The carbon dioxide laser has been used clinically in both otorhinolaryngology and neurological surgery for approximately 10 years. Only recently, however, have technical modifications allowed its use with the operating microscope, providing the increased precision and control necessary for intracranial surgery. This paper reports the authors' experience with the carbon dioxide laser in the removal of acoustic tumors, details the surgical technique involved, and describes the advantages that may accompany the use of the laser in the removal of these difficult lesions.

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Microendoscopic Surgery of the Hypopharyngeal Diverticulum Using Electrocoagulation or Carbon Dioxide Laser

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948409300108 ◽

1984 ◽

Vol 93 (1) ◽

pp. 34-36 ◽

Cited By ~ 76

Author(s):

Jos J. M. van Overbeek ◽

Paul E. Hoeksema ◽

Enje Th. Edens

Keyword(s):

Carbon Dioxide ◽

Great Improvement ◽

Carbon Dioxide Laser ◽

Operating Microscope ◽

Number Of Patients ◽

Hypopharyngeal Diverticulum

In 1964 we started to treat hypopharyngeal (Zenker's) diverticula endoscopically, using the procedure described by Dohlman. With the increase in the number of patients (274 patients up until 1982), the technique and the instruments used have improved. This paper describes the technique we have used since 1981, which involves exposure of the tissue bridge between esophagus and diverticulum with the aid of a specially designed scope and subsequent severance of this bridge under microscopic control. In 12 cases the bridge was severed by electrocoagulation, while the CO2 laser was used for this purpose in another 12 cases. Both techniques have given good results. Essential advantages or disadvantages of either of these methods could not be elicited. We regard the use of an operating microscope as a great improvement.

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Features of CO2-laser application in surgical treatment of chronic cicatrical stenoses of the larynx

Medical Council ◽

10.21518/2079-701x-2020-6-108-113 ◽

2020 ◽

pp. 108-113

Author(s):

V. V. Vavin ◽

I. I. Nazhmudinov ◽

Kh. Sh. Davudov ◽

T. I. Garashchenko ◽

B. Kh. Davudova ◽

...

Keyword(s):

Carbon Dioxide ◽

Surgical Treatment ◽

Carbon Dioxide Laser ◽

High Tech ◽

Operating Microscope ◽

Laser Application ◽

Operating Modes ◽

Surgical Manipulations ◽

Operating Surgeon ◽

Main Operating

The aim of the review is to identify current possibilities of carbon dioxide laser application in microsurgical treatment of chronic laryngeal cicatricial stenoses. Currently, laser endolaryngeal surgeries are one of the main standards in surgical treatment of patients with this laryngeal pathology, including when providing high-tech assistance. Various types of lasers and methods of surgical treatment of the larynx are used. The choice of these methods is primarily determined by the opinion of the operating surgeon. The review highlights the principles of laser surgery in general, and when using carbon dioxide laser in particular. The use of micromanipulators makes it possible to combine the work of carbon dioxide laser with the operating microscope, affecting target tissues noninvasively with maximum precision. This technology makes it possible to expand the range of surgical manipulations in endolaryngeal surgeries. The main operating modes of the carbon dioxide laser, applicable for different clinical situations, such as power, impulse, laser power density (PD) are considered. In addition, the combination of a micromanipulator with an operating microscope allows the use of additional techniques aimed at preventing restenosis, such as the use of microflaps, submucosal laryngeal cicatricial tissue vaporization. The possibilities of the recurrence of cicatricial stenosis by different variants of stenting are presented. The risk of complications of this technique is not higher than in other types of larynx laser surgeries, and with proper preventive measures can be minimized. In the review, possible complications, both early and late, measures of their prophylaxis, as well as ways to eliminate their consequences are analyzed in detail.

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Laryngeal Problems in Children

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348948709600130 ◽

1987 ◽

Vol 96 (1) ◽

pp. 124-126 ◽

Cited By ~ 4

Author(s):

Blair Fearon

Keyword(s):

Carbon Dioxide ◽

Carbon Dioxide Laser ◽

Subglottic Stenosis ◽

Operating Microscope ◽

Pediatric Otolaryngology ◽

Laryngeal Surgery ◽

Laryngeal Tuberculosis

Some diseases of the larynx that now are rare were common in 1950, when the author began the practice of pediatric otolaryngology. These include laryngeal tuberculosis, bulbar poliomyelitis, and acute exanthemata. The management of laryngotracheitis and supraglottitis has altered markedly, with the mortality reduced drastically. The advent of the operating microscope and carbon dioxide laser has broadened the efficacy of laryngeal surgery. Subglottic stenosis continues to be a challenge despite new operations. Laryngeal transplant may be the answer to some intractable diseases.

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Intramedullary Subependymoma of the Cervical Spinal Cord: Case Report

Neurosurgery ◽

10.1227/00006123-198405000-00019 ◽

1984 ◽

Vol 14 (5) ◽

pp. 608-611 ◽

Cited By ~ 22

Author(s):

Michael Salcman ◽

Richard Mayer

Keyword(s):

Carbon Dioxide ◽

Spinal Cord ◽

Case Report ◽

Somatosensory Evoked Potentials ◽

Clinical Setting ◽

Carbon Dioxide Laser ◽

Cervical Spinal Cord ◽

Operating Microscope ◽

Aged Patients ◽

The Third

Abstract The third case of intramedullary subependymoma of the cervical spinal cord is reported. This is the first such case for which intraoperative views are available. It was possible to remove most of this lesion with the aid of the operating microscope, the carbon dioxide laser, and the use of somatosensory evoked potentials. The diagnosis was clouded by the coexistence of Holmes-Adie pupils and absent reflexes in the lower extremities. All three reported intramedullary subependymomas have been found in the cervical spinal cord of middle-aged patients. Tumors in this clinical setting should not be assumed to be unresectable astrocytomas without careful histopathological and intraoperative evaluation.

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Electron Cytochemical Study of Carbon Dioxide Laser Effect on Rhesus Monkey Cornea

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010005113x ◽

1974 ◽

Vol 32 ◽

pp. 224-225

Author(s):

K. C. Tsou ◽

J. Morris ◽

P. Shawaluk ◽

B. Stuck ◽

E. Beatrice

Keyword(s):

Carbon Dioxide ◽

Electron Microscope ◽

Rhesus Monkey ◽

Carbon Dioxide Laser ◽

Cytochemical Study ◽

Laser Effect

While much is known regarding the effect of lasers on the retina, little study has been done on the effect of lasers on cornea, because of the limitation of the size of the material. Using a combination of electron microscope and several newly developed cytochemical methods, the effect of laser can now be studied on eye for the purpose of correlating functional and morphological damage. The present paper illustrates such study with CO2 laser on Rhesus monkey.

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