Fukuyama T, Matsuo K, Maeyama T, Shin T
Department of Otolaryngology, Saga Medical School.
Nihon Jibiinkoka Gakkai Kaiho. 1990 Feb;93(2):207-18. doi: 10.3950/jibiinkoka.93.207.
Recently, the Nd-YAG laser has been widely applied for head and neck surgery. This medical instrument provides several advantages, including hemostatic efficacy and cutting capability which are dependent on manipulation. The purpose of this study is to discuss the clinical application of Nd-YAG laser in the field of oropharyngeal surgery. For this reason, the canine tongue is used in this study. After irradiation by Nd-YAG laser, observations were performed on histological findings, measurement of tissue temperature and changes in blood vessels. The results obtained are as follows: 1) Irreversible tissue changes were found in the center of the irradiated area, with other tissue degeneration occurring in the surrounding areas. 2) Within the coagulated degenerative area, blood vessels were completely embolized. 3) Temperature measurements revealed that there were minimal effects on the surrounding tissues. 4) The coagulated degenerative area was replaced by granulation tissue subsequently occurring after wound healing. 5) The Nd-YAG laser was useful for oral and paranasal surgery, because these diseases are localized in the cavity. 6) Non-contact type Nd-YAG laser was indicated for vaporization of the lesions and was particularly useful for vaporizing superficial benign lesions. In this case, close range, low power vaporization is recommended. Conversely, vaporization for hemangioma and/or malignant lesions were most effective with high power irradiation. 7) Contact type Nd-YAG laser might be suitable for cutting and excision of lesions, but careful attention must be given determining the safety margin for application in malignant lesions, because tissue degeneration when using contact type Nd-YAG laser is less reactive than in non-contact type.
最近，钕钇铝石榴石激光已广泛应用于头颈外科手术。这种医疗器械具有多种优势，包括止血效果和切割能力，这取决于操作方式。本研究的目的是探讨钕钇铝石榴石激光在口咽外科领域的临床应用。因此，本研究使用犬舌。在钕钇铝石榴石激光照射后，对组织学结果、组织温度测量和血管变化进行了观察。获得的结果如下：1）在照射区域中心发现不可逆的组织变化，周围区域出现其他组织变性。2）在凝固性变性区域内，血管完全栓塞。3）温度测量显示对周围组织影响极小。4）凝固性变性区域随后在伤口愈合后被肉芽组织取代。5）钕钇铝石榴石激光对口腔和鼻旁窦手术有用，因为这些疾病局限于腔内。6）非接触式钕钇铝石榴石激光适用于病变的汽化，对浅表良性病变的汽化尤其有用。在这种情况下，建议近距离、低功率汽化。相反，对血管瘤和/或恶性病变的汽化在高功率照射下最有效。7）接触式钕钇铝石榴石激光可能适用于病变的切割和切除，但在确定恶性病变应用的安全 margins 时必须格外小心，因为使用接触式钕钇铝石榴石激光时组织变性的反应性比非接触式小。 （注：原文中“safety margin”直译为“安全 margin”，可能是“安全边界”之类的专业术语，这里保留英文以便准确传达原文信息）
