Kass E G, Massaro B M, Komorowski R A, Toohill R J
Department of Otolaryngology, Medical College of Wisconsin, Milwaukee.
Otolaryngol Head Neck Surg. 1993 Mar;108(3):283-92. doi: 10.1177/019459989310800313.
The potassium titanyl phosphate (KTP) and argon lasers are increasingly used in nasal and sinus surgery. Histologic effects of these lasers on living nasal tissue have not been investigated. Sixteen dogs underwent laser nasal surgery (eight for each laser). Flexible fiberoptic quartz fibers were used with both lasers to deliver the laser energy to the tissue. The dogs were allowed to heal and then underwent biopsy at 3, 7, 21, and 90 days postoperatively. The argon and KTP lasers had similar tissue effects. Histologically, a thin rim of coagulation necrosis and acute inflammation were seen at 3 days postoperatively. By 7 days, fibroblasts and granulation tissue were observed. At 21 days, fibroblast proliferation and re-epithelialization with respiratory epithelium were the predominant findings. Finally, at 90 days postoperatively, respiratory epithelium and submucosal structures were found overlying a plug of scar filling the defect in the septal cartilage. This healing was consistent through a wide range of energy densities. These lasers are easily used with sinus endoscopes and the operating microscope to allow access to difficult areas. These factors and the wound-healing characteristics noted in this study would seem to make them suited for use in rhinologic surgery.
磷酸钛氧钾（KTP）激光和氩激光越来越多地应用于鼻腔和鼻窦手术。尚未对这些激光对活体鼻腔组织的组织学效应进行研究。16只犬接受了激光鼻腔手术（每种激光8只）。两种激光均使用柔性光纤石英纤维将激光能量传递至组织。让犬愈合，然后在术后3天、7天、21天和90天进行活检。氩激光和KTP激光具有相似的组织效应。组织学上，术后3天可见一层薄的凝固性坏死和急性炎症边缘。到7天时，观察到成纤维细胞和肉芽组织。在21天时，主要表现为成纤维细胞增殖和呼吸道上皮再上皮化。最后，术后90天时，在填充鼻中隔软骨缺损的瘢痕栓上方发现呼吸道上皮和黏膜下结构。在广泛的能量密度范围内，这种愈合情况是一致的。这些激光易于与鼻窦内窥镜和手术显微镜配合使用，以便进入困难区域。本研究中指出的这些因素和伤口愈合特征似乎使其适用于鼻科手术。
