Karakkandy Vinusree, Chappity Preetam, Mishra Pritinanda, Parida Pradipta Kumar, Patra Susama, Giri Prajna Paramita, Pradhan Pradeep, Samal Dillip Kumar, Sarkar Saurav, Swain Santosh, Kallyadan Veetil Aswathi
Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, 751019 Odisha India.
Department of Pathology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4596-4601. doi: 10.1007/s12070-024-04932-0. Epub 2024 Jul 25.
CO Laser and Coblation are widely used in Head and neck Surgeries. This study compares the tissue changes produced by these two techniques. 50 Patients who underwent complete excision of benign and malignant pathologies in the Oral Cavity, Oropharynx, and Larynx with Coblation and CO Laser were included in the study. The primary excised specimen and another separate specimen from the base of the excised lesion were evaluated histologically based on criteria by Vescovi et al. (1). On histopathological examination, thermal effects (epithelial, connective tissue and vascular) produced by both techniques were comparable. However vascular changes were seen more in tissues CO Laser ( = 0.727). Incision margins were more regular in the CO Laser group (73%) than in Coblation (55%) but not statistically significant ( = 1.80). Depth of thermal damage ( = 0.171) and connective tissue changes( = 0.279) was more with Coblation. Both Coblation and CO Laser can be used effectively in Head and Neck cases. CO Laser, when available, is a better option because of its precise excision, and less collateral tissue damage.
CO2激光和低温等离子消融术在头颈外科手术中被广泛应用。本研究比较了这两种技术所产生的组织变化。50例接受了低温等离子消融术和CO2激光治疗的口腔、口咽和喉部良性及恶性病变完全切除手术的患者被纳入研究。根据Vescovi等人（1）的标准，对切除的主要标本和来自切除病变底部的另一个单独标本进行组织学评估。在组织病理学检查中，两种技术产生的热效应（上皮、结缔组织和血管）具有可比性。然而，CO2激光治疗的组织中血管变化更为明显（P = 0.727）。CO2激光组的切缘比低温等离子消融术组更整齐（73%对55%），但差异无统计学意义（P = 1.80）。低温等离子消融术造成的热损伤深度（P = 0.171）和结缔组织变化（P = 0.279）更大。低温等离子消融术和CO2激光均可有效地用于头颈疾病的治疗。在可行的情况下，CO2激光是更好的选择，因为它切除精确，对周围组织的损伤较小。
