Brophy J W, Scully P A, Stratton C J
Laryngoscope. 1982 Oct;92(10 Pt 1):1164-7.
Papillomas of the larynx are discussed, including the use of lasers. Argon lasers' differences from CO2 lasers and techniques are outlined. Case reports are given in which laryngeal papillomas were removed from two patients with the argon laser and examined by transmission electron microscopy (TEM), scanning electron microscopy (SEM), and stereoscanning electron microscopy (SSEM). The depth and width of morphological change are noted. Peripheral to the laser impact site, four zones were observed: 1. coagulation necrosis, 2. contracted epithelial cells, 3. minimally damaged epithelial cells, and 4. morphologically undamaged epithelial cells. In Zone 2, cells were violently popped-off as heat was conducted through the epithelium. The potential for spread of papillomas was discussed and suction of the vapor plume recommended when removing laryngeal papillomas with the argon laser.
本文讨论了喉乳头状瘤,包括激光的应用。概述了氩激光与二氧化碳激光的区别及技术。给出了病例报告,其中两名患者的喉乳头状瘤用氩激光切除,并通过透射电子显微镜(TEM)、扫描电子显微镜(SEM)和立体扫描电子显微镜(SSEM)进行检查。记录了形态学变化的深度和宽度。在激光作用部位周围,观察到四个区域:1. 凝固性坏死;2. 收缩的上皮细胞;3. 轻度受损的上皮细胞;4. 形态学上未受损的上皮细胞。在区域2中,当热量通过上皮传导时,细胞剧烈脱落。讨论了乳头状瘤的扩散可能性,并建议在使用氩激光切除喉乳头状瘤时抽吸蒸汽羽流。