Miyaguchi M, Sakai S
Department of Otorhinolaryngology, Kagawa Medical School, Japan.
Auris Nasus Larynx. 1994;21(4):226-31. doi: 10.1016/s0385-8146(12)80085-x.
Nine oral and oropharyngeal squamous cell carcinomas were removed with a contact Nd-YAG laser. Clinical and morphological studies on wound healing and effects of the Nd-YAG laser were performed. The wounds were not sutured and patients did not complain of any severe symptoms. The wound healing was prolonged to 3-6 weeks. Cells and glands degenerated at a depth of 2-3 mm by the direct effects of the laser. The epithelium exhibited acantholysis 5 mm from the site of laser injury. Scanning electron microscopy showed no coagulation or other coated material in the wound created by a surgical knife, while the wound surface by laser consisted of carbonization, well-coated and non-coated areas. These findings varied with the laser power. The coagulation and thermal effects of the Nd-YAG laser resulted in autolysis of tumor cells at least within 5 mm of the cutting surface. The contact Nd-YAG laser was useful for the removal of the malignant tumor in the oral cavity and oropharynx where it is difficult to maintain a generous safety margin.
采用接触式Nd-YAG激光切除9例口腔和口咽鳞状细胞癌。对伤口愈合情况及Nd-YAG激光的效果进行了临床和形态学研究。伤口未缝合，患者未诉任何严重症状。伤口愈合延长至3 - 6周。激光的直接作用使细胞和腺体在2 - 3毫米深度处发生变性。上皮在距激光损伤部位5毫米处出现棘层松解。扫描电子显微镜显示，手术刀造成的伤口中没有凝血或其他覆盖物，而激光造成的伤口表面由碳化、良好覆盖和未覆盖区域组成。这些发现随激光功率而变化。Nd-YAG激光的凝固和热效应导致肿瘤细胞至少在切割表面5毫米范围内自溶。接触式Nd-YAG激光对于切除口腔和口咽部位难以保持足够安全切缘的恶性肿瘤很有用。
