喉部手术中的新工具：皮秒红外激光的初步结果。
A novel tool in laryngeal surgery: preliminary results of the picosecond infrared laser.
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, Max Planck Research Department for Structural Dynamics, University of Hamburg, Hamburg, Germany.
出版信息
Laryngoscope. 2013 Nov;123(11):2770-5. doi: 10.1002/lary.24124. Epub 2013 May 13.
OBJECTIVES/HYPOTHESIS: Conventional lasers ablate tissue through photothermal, photomechanical, and/or photoionizing effects, which may result in collateral tissue damage. The novel nonionizing picosecond infrared laser (PIRL) selectively energizes tissue water molecules using ultrafast pulses to drive ablation on timescales faster than energy transport to minimize collateral damage to adjacent cells.
STUDY DESIGN
Animal cadaver study.
METHODS
Cuts in porcine laryngeal epithelium, lamina propria, and cartilage were made using PIRL and carbon dioxide (CO₂) laser. Lateral damage zones and cutting gaps were histologically compared.
RESULTS
The mean widths of epithelial (8.5 μm), subepithelial (10.9 μm), and cartilage damage zones (8.1 μm) were significantly lower for cuts made by PIRL compared with CO₂ laser (p < 0.001). Mean cutting gaps in vocal fold (174.7 μm) and epiglottic cartilage (56.3 μm) were significantly narrower for cuts made by PIRL compared with CO₂ laser (P < 0.01, P < 0.05).
CONCLUSION
PIRL ablation demonstrates superiority over CO₂ laser in cutting precision with less collateral tissue damage.
目的/假说：传统激光通过光热、光机械和/或光电离效应来消融组织，这可能导致相邻组织损伤。新型非电离皮秒红外激光（PIRL）使用超快脉冲选择性地激发组织水分子，以在比能量传递更快的时间尺度上驱动消融，从而最大限度地减少对相邻细胞的附带损伤。
研究设计
动物尸体研究。
方法
使用 PIRL 和二氧化碳（CO₂）激光对猪喉上皮、固有层和软骨进行切割。对横向损伤区和切割间隙进行组织学比较。
结果
与 CO₂激光相比，PIRL 切割的上皮（8.5μm）、上皮下（10.9μm）和软骨损伤区（8.1μm）的平均宽度显著更窄（p<0.001）。与 CO₂激光相比，声带（174.7μm）和会厌软骨（56.3μm）的平均切割间隙明显更窄（P<0.01，P<0.05）。
结论
PIRL 消融在切割精度方面优于 CO₂激光，且对相邻组织的损伤更小。
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