Use of lasers in laryngeal surgery.
Use of lasers in laryngeal surgery.
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DOI：
10.1016/j.jvoice.2008.09.006
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发表时间：
2010-01
期刊：
影响因子：
--
通讯作者：
Jiang JJ
中科院分区：
文献类型：
--
作者：
Yan Y;Olszewski AE;Hoffman MR;Zhuang P;Ford CN;Dailey SH;Jiang JJ
激光是喉部手术的一个相对较新的补充。自发明以来，激光的使用和应用迅速扩大。在本文中，我们讨论了激光在不同手术中的优点和缺点，以及克服临床上常见问题的方法。激光在外科手术中的使用为冷外科技术提供了一种既省时又经济的替代方法，并已被用于治疗多种喉部病变，包括狭窄、复发性呼吸道乳头状瘤病、白斑、结节、喉部恶性疾病和息肉样变性(Reinke‘s水肿)。然而，激光可能会导致邻近组织损伤和声带疤痕。通过了解激光工作的机制并在外科医生的控制下正确地操纵参数，这些问题可以被最小化。通过改变通量、功率密度和脉动，可以减少组织损伤，并且可以更有信心地使用激光。回顾了各种类型的激光及其在特定病理治疗中的应用，旨在帮助外科医生为特定的手术选择最好的工具。最近激光在治疗良性喉部病变和严重喉软化方面的应用表明，为了充分发挥这种手术工具的潜力，必须进行更多的研究。
Lasers are a relatively recent addition to laryngeal surgery. Since their invention, laser use and applications have expanded rapidly. In this paper, we discuss the benefits and disadvantages of lasers for different procedures, as well as ways to overcome commonly faced clinical problems. The use of lasers in surgery has offered a time- and cost-efficient alternative to cold surgical techniques, and has been employed in the treatment of numerous laryngeal pathologies, including stenoses, recurrent respiratory papillomatosis, leukoplakia, nodules, malignant laryngeal disease, and polypoid degeneration (Reinke’s edema). However, lasers can incur adjacent tissue damage and vocal fold scarring. These problems can be minimized through understanding the mechanisms by which lasers function and correctly manipulating the parameters under a surgeon’s control. By varying fluence, power density, and pulsation, tissue damage can be decreased and lasers can be used with greater confidence. The various types of lasers and their applications to the treatment of specific pathologies are reviewed with the intention of helping surgeons select the best tool for a given procedure. Recent applications of lasers to treat benign laryngeal lesions and severe laryngomalacia demonstrate that additional research must be conducted in order to realize the full potential of this surgical tool.
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