Treatment of Tracheal and Endobronchial Lesions with the Potassium Titanyl Phosphate Laser

1992 ◽  
Vol 101 (3) ◽  
pp. 205-208 ◽  
Author(s):  
Robert F. Ward
Keyword(s):  
Carbon Dioxide ◽  
Delivery System ◽  
Carbon Dioxide Laser ◽  
Pediatric Patients ◽  
Potassium Titanyl Phosphate ◽  
Ktp Laser ◽  
Management Problem ◽  
Quartz Fiber ◽  
And Control ◽  
Potassium Titanyl Phosphate Laser

Lower tracheal and endobronchial lesions represent a difficult management problem. While there has been some success in the treatment of these lesions with the carbon dioxide laser, the limitations of its delivery system have restricted its use in infants and neonates. The potassium titanyl phosphate (KTP) laser, transmitted via a flexible quartz fiber, can be precisely manipulated even through rigid pediatric bronchoscopes as small as 3.0 mm. In addition, the Hopkins telescopic lens may be used to improve visualization and control. We report our experience using the KTP laser to treat 15 pediatric patients with tracheal and endobronchial lesions. The nature of the lesions, the details of the technique, and the results are presented.

Use of the Carbon Dioxide Laser for Acoustic Tumor Surgery

Neurosurgery ◽  
1983 ◽  
Vol 12 (3) ◽  
pp. 286-290 ◽  
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.

Transmucosal Cricopharyngeal Myotomy with the Potassium-Titanyl-Phosphate Laser in the Treatment of Cricopharyngeal Dysmotility

1994 ◽  
Vol 103 (3) ◽  
pp. 173-177 ◽  
Author(s):  
David J. Halvorson ◽  
Frederick A. Kuhn
Keyword(s):  
Diagnostic Tests ◽  
Potassium Titanyl Phosphate ◽  
Ktp Laser ◽  
Cricopharyngeal Myotomy ◽  
Significant Morbidity ◽  
Therapeutic Tool ◽  
Current Trends ◽  
Cricopharyngeal Dysfunction ◽  
Pharyngeal Swallowing ◽  
Potassium Titanyl Phosphate Laser

Cricopharyngeal dysfunction is a relatively uncommon disorder that is widely misunderstood. Cricopharyngeal dysmotility is thought to represent abnormal function of the upper esophageal or cricopharyngeal sphincter. The cause of this dysfunction is related to uncoordinated pharyngeal swallowing, achalasia, or a combination of these factors. Unfortunately, standard diagnostic tests have not consistently demonstrated a failure of the cricopharyngeal sphincter to malfunction; therefore, cricopharyngeal myotomy has been suggested as a diagnostic and therapeutic tool in the treatment of dysmotility. Our report focuses on the current trends in the diagnosis and treatment of cricopharyngeal dysfunction. We also present a case report of a transmucosal cricopharyngeal myotomy performed with the potassium-titanyl-phosphate (KTP) laser. The KTP laser was found to be relatively safe and effective and did not demonstrate significant morbidity. Our conclusion was that a transmucosal cricopharyngeal myotomy with the KTP laser may represent a viable alternative for patients with cricopharyngeal dysmotility.

Benign Lesions of the Nose, Oral Cavity, and Oropharynx in Children: Excision by Carbon Dioxide Laser

1985 ◽  
Vol 94 (5) ◽  
pp. 489-493 ◽  
Author(s):  
Dennis M. Crockett ◽  
Trevor J. I. McGill ◽  
Gerald B. Healy ◽  
Ellen M. Friedman
Keyword(s):  
Carbon Dioxide ◽  
Oral Cavity ◽  
Airway Obstruction ◽  
Carbon Dioxide Laser ◽  
Pediatric Patients ◽  
Upper Aerodigestive Tract ◽  
Benign Lesions ◽  
Hemostatic Effect ◽  
Incomplete Removal ◽  
Laser Excision

The carbon dioxide laser was used to treat a group of pediatric patients with benign lesions of the upper aerodigestive tract exclusive of the larynx Prior to development of the CO2 laser, excision of these lesions by conventional means often resulted in incomplete removal, significant bleeding, and postoperative edema resulting in airway obstruction. The CO2 laser, with its unique properties of precise excision, hemostatic effect and minimal postoperative edema, has become the instrument of choice in the removal of these lesions.

scholarly journals The Use of 532-Nanometer-Pulsed Potassium-Titanyl-Phosphate (KTP) Laser in Laryngology: A Systematic Review of Current Indications, Safety, and Voice Outcomes

2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 4S-13S
Author(s):  
Jerome R. Lechien ◽  
James A. Burns ◽  
Lee M. Akst
Keyword(s):  
Vocal Fold ◽  
Carbon Dioxide Laser ◽  
Treatment Effectiveness ◽  
Outcome Evaluation ◽  
Potassium Titanyl Phosphate ◽  
Cochrane Library ◽  
Ktp Laser ◽  
Vocal Fold Vibration ◽  
Laryngeal Disease ◽  
Meta Analyses

Objective: To investigate the indications, efficacy, safety, and outcomes of potassium-titanyl-phosphate (KTP) laser procedures for treatment of laryngeal disease. Methods: PubMed, Cochrane Library, and Scopus were searched for studies providing information about the indications, efficacy, and safety of both in-office and operative suspension microlaryngoscopy KTP laser procedure in treatment of laryngeal disease. Diagnostic criteria and clinical outcome evaluation of included studies were analyzed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Results: Of the initial screened 140 papers, 17 met our inclusion criteria. Six papers involved KTP laser procedures for benign and malignant vocal fold lesions in suspension microlaryngoscopy only, 10 papers focused on only in-office KTP laser procedures for benign vocal fold lesions, and 1 paper included both in-office and suspension microlaryngoscopy procedures. The following lesions may be considered as indications for KTP laser procedures: Reinke’s edema, sulcus vocalis, vocal fold hemorrhage, polyp, granuloma, cyst, scar, papillomatosis, dysplasia, leukoplakia, and early vocal fold malignancies. Irrespective of the types of procedure (in-office vs suspension microlaryngoscopy), the KTP laser is associated with a low complication rate and overall good vocal fold vibration recovery. There is an important heterogeneity among studies concerning laser settings, indications, and outcomes used for the assessment of treatment effectiveness. There are no controlled studies directly comparing KTP laser with other lasers (ie, carbon dioxide laser). Conclusion: The use of KTP laser procedures for treatment of laryngeal disease has increased over the past decade, especially for office-based management of vocal fold lesions. Future controlled studies are needed to compare the safety and outcomes of the KTP laser to other techniques.

The Effectiveness of Laser Therapy for Hypertrophic Burn Scars in Pediatric Patients: A Prospective Investigation

2021 ◽  
Author(s):  
Jennifer Zuccaro ◽  
Charis Kelly ◽  
Manuela Perez ◽  
Andrea Doria ◽  
Joel S Fish
Keyword(s):  
Carbon Dioxide ◽  
Laser Therapy ◽  
Carbon Dioxide Laser ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Dye Laser ◽  
Pulsed Dye Laser ◽  
Assessment Protocol ◽  
Scar Assessment ◽  
Fractional Carbon Dioxide Laser

Abstract Laser therapy has become a valuable treatment option for hypertrophic burn scars. Improvements in scar symptoms have been achieved using the ablative fractional carbon dioxide laser as well as the pulsed dye laser. However, research regarding the use of laser therapy among pediatric patients remains limited. Thus, the aim of this study was to investigate the effectiveness of using laser therapy to improve hypertrophic burn scars in a pediatric population using a comprehensive scar assessment protocol. A pragmatic, single-center, prospective observational study was conducted at a tertiary pediatric hospital. Twenty participants with hypertrophic burn scars were included. Laser procedures were administered at approximately two month intervals and scars were evaluated at five time-points over one year using the Vancouver Scar Scale, the Patient and Observer Scar Assessment Scale, conventional ultrasound, ultrasound elastography, and a multi-probe skin analysis device. Seventy-one laser procedures were performed with most participants receiving treatment with both the ablative fractional carbon dioxide laser and the pulsed dye laser at the same session (83%). From baseline to study completion, significant improvements in all scar measures were observed (p < 0.05). In particular, improvements in overall scarring and in specific scar properties including thickness, stiffness, and colour were found (p < 0.05). To our knowledge, this is the most comprehensive study to date to evaluate the effect of laser treatment on hypertrophic burn scars in a pediatric population. Our findings suggest that laser therapy is a beneficial treatment for burn-injured children as evidenced by the improvements in subjective and objective scar assessment measures.

Variations in Stapes Surgery Cost within a Multihospital Network

2019 ◽  
Vol 161 (5) ◽  
pp. 835-841 ◽  
Author(s):  
Geoffrey C. Casazza ◽  
Andrew J. Thomas ◽  
Jesse Dewey ◽  
Richard K. Gurgel ◽  
Clough Shelton ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Carbon Dioxide Laser ◽  
Case Series ◽  
Correlation Coefficients ◽  
Stapes Surgery ◽  
Study Cohort ◽  
Ktp Laser ◽  
Accounting System ◽  
Cost Variation ◽  
Close Time

ObjectiveTo identify costs and operative times for stapedotomy and evaluate factors influencing cost variation.Study DesignCase series with cost analysis.SettingMultihospital network.Subjects and MethodsA multihospital network’s standardized activity-based accounting system was used to determine costs and operative times of all patients undergoing stapedotomy from 2013 to 2017. Subjects with additional procedures were excluded. Correlations between variable factors and cost were calculated by Spearman correlation coefficients. Audiometric and cost data were compared with a Mann-Whitney U test.ResultsThe study cohort included 176 stapedotomies performed by 23 surgeons at 10 hospitals. Mean ± SD patient age was 44.3 ± 17.4 years. Mean cut-to-close time was 61.1 ± 23.55 minutes. Mean total encounter cost was $3542.14 ± $1258.78 (US dollars). Significant factors correlating with increased total encounter cost were surgical supply cost ( r = 0.74, P < .0001) and cut-to-close time ( r = 0.66, P < .0001). Laser utilization ($563.37 ± $407.41) was the highest-cost surgical supply, with the carbon dioxide laser being significantly more costly than the potassium titanyl phosphate (KTP; $852.60 vs $230.55, P < .001). Additionally, the carbon dioxide laser was associated with a significantly higher mean total encounter cost than the KTP laser ($4645.43 vs $2903.00, P < .001) and cases where no laser was used ($4645.43 vs $2932.47, P < .001). There was no difference in mean total encounter cost between the KTP laser and cases of no laser use ($2903.00 vs $2932.47, P = .75).ConclusionsSignificant cost variation exists in stapes surgery. Surgical supply cost, specifically laser use, may be associated with significantly increased costs. Reducing variation in costs while maintaining outcomes may improve health care value.

Use of potassium titanyl phosphate (KTP) laser Dermastat in the treatment of recurrent anterior epistaxis – a new technique

2016 ◽  
Vol 130 (9) ◽  
pp. 822-826 ◽  
Author(s):  
A Jain ◽  
S J Frampton ◽  
R Sachidananda ◽  
P K Jain
Keyword(s):  
Potassium Titanyl Phosphate ◽  
Ktp Laser ◽  
Recurrent Epistaxis ◽  
Group A ◽  
Resistant Group ◽  
A New Technique ◽  
The Right ◽  
Potassium Titanyl Phosphate Laser ◽  
Little’S Area

AbstractObjective:To evaluate the short- to medium-term effectiveness of potassium titanyl phosphate (KTP) laser Dermastat in patients with recurrent anterior epistaxis.Method:Fifty-eight patients presenting with recurrent anterior epistaxis were treated using potassium titanyl phosphate laser Dermastat. Those with recurrent epistaxis arising from prominent vessels in Little's area, and/or those for whom treatment with silver nitrate cautery failed, were included. The main outcome measure was resolution of epistaxis at two months.Results:Fifty-eight patients were treated; 27 were under 18 years old. Thirty patients had prominent vessels. Thirty-one patients had undergone previous cautery treatment. Thirty-eight patients had treatment to the left side, 19 to the right and 1 to both. At two months, 74 per cent reported resolution of epistaxis with no complications. This increased to 78 per cent at further follow up.Conclusion:Our technique is a successful, safe treatment for recurrent anterior epistaxis in an otherwise treatment-resistant group. A single procedure is effective. The handpiece and tip are reusable and sterilisable, resulting in cost-effectiveness.

Tracheoesophageal speech following transmucosal pharyngeal myotomy with the potassium-titanyl-phosphate laser

1997 ◽  
Vol 111 (7) ◽  
pp. 659-662 ◽  
Author(s):  
David J. Halvorson ◽  
Frederick A. Kuhn
Keyword(s):  
Potassium Titanyl Phosphate ◽  
Ktp Laser ◽  
Functional Difficulties ◽  
Alaryngeal Speech ◽  
Successful Communication ◽  
Upper Oesophageal Sphincter ◽  
Tracheoesophageal Speech ◽  
Tracheoesophageal Puncture ◽  
Potassium Titanyl Phosphate Laser ◽  
Successful Production

AbstractSuccessful communication following laryngectomy usually involves an electrolarynx or oesophageal speech. Only within the past decade has tracheoesophageal puncture been advocated for alaryngeal speech and evolved into the procedure of choice. Successful production of speech after total laryngectomy using tracheoesophageal speech may be impaired secondary to anatomical and functional difficulties. The primary limitation of tracheoesophageal speech is pharyngoesophageal spasm occurring in the upper oesophageal sphincter impeding airflow through this segment. Our report presents four patients who underwent a pharyngeal myotomy with the potassium-titanyl-phosphate (KTP) laser. Post-operatively, each patient was able to communicate with functional alaryngeal speech. A transmucosal pharyngeal myotomy may represent an alternative for patients with speech failure after tracheoesophageal puncture.

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