STUDY OF CO2 LASER IN OTOLARYNGOLOGY - Medical Fibers

Keywords:otolaryngology, medical, fibers,  Time:23-02-2016

It is the most widely used, well understood, and well studied of all the medical lasers and is used for incision, excision and vaporization of tissue. It was first used clinically in ENT by strong and Jako (1972)1. It was Einstein in 1917 who discussed stimulated Emissions2.

In 1958 Townes publishes first theoretic calculations of then titled laser fibers. In 1961, Neodynium doped was developed followed by Nd: YAG and Argon in 19644-6. In this study different types of otolaryngology surgical cases were operated with laser and conventional technique.

We have discussed the advantages and disadvantages of laser. The laser approach though successful can be technically challenging. The purpose of the current study was to compare operative results of surgical cases using laser and with conventional technique, and also to compare the outcome between both techniques.

It is a prospective study from 2011 to 2012, carried out in department of ENT, GMERS medical college sola.

Out of 90 patients, only 89 were included in this study as they were regular in follow up.  In this study, different otolaryngology surgical cases were taken up which includes Vocal cord nodule (9), Vocal cord polyp (3), Tonsillitis (23), sub mucous fibrosis (2), Oral cavity growth and leucoplakia (18), Endoscopic dacryocystorhinostomy (31) and Ear lobe keloid (3). Besides a detailed history and complete ENT examination was done. Patients were explained regarding laser complication and advantages and disadvantages. Proper consent was taken. Surgery with medical laser fibers or without laser was based on surgeon preference. Post operatively patients were examined at 1 week, 1 month, and 3 months thereafter.

The Paired samples (t) test was used to calculate the change in pre operative and postoperative parameter such as pain, bleeding, voice change. Independent sample t test and x2 nonparametric analysis were used to compare numerical variables and proportions respectively b/w laser and nonlaser cases. The Fisher exact test was used to examine probability of success. Statistical analysis was carried out using Excel.

Eighty nine patient [(Male (29), female (60), mean age (31.5)], underwent surgery. Of these 50 were operated with laser. Demographics of the study population are summarized in table 1 while comparison of data shown in table 2. In Post op pain, haemostasis, intraoperative bleeding P value (<.05) which was significant in laser cases (degree of freedom=1).