Fiberoptic Laser Systems in Otolaryngology (Ent)

FIBEROPTIC LASER SYSTEMS IN
OTOLARYNGOLOGY(ENT)
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Introduction
Otolaryngology is a medical specialty which is focused on the ears, nose, and

throat. It is also called otolaryngology-head and neck surgery because specialists
are trained in both medicine and surgery.
Natural entrances make it simple to access the ear, nose, and throat (ENT).
Simple optical systems that have been in use for decades allowed for the
illumination and clear imaging of interior components.
Mechanical tools such as grasping or cutting tools could also be easily
introduced into these natural openings
The electrical and cryogenic surgical tools result in uncontrollable thermal
damage to neighbouring tissue, which is often unacceptable in otolaryngology
Lasers, such as the C02 or excimer lasers, are preferable because they remove
tissue in a controlled way and with little thermal damage
With the development of rigid endoscopes, it was possible to obtain excellent
images of deeper zones in the larynx or the bronchus
Laser beams sent through these endoscopes have been used for surgery and
therapy.
Endoscopic Laser Surgery- Larynx, Pharynx, and Oral
Cavity
Endoscopic laser surgery (also called transoral laser microsurgery) may be used to treat
early stage laryngeal tumors.
 Endoscopic surgery is less invasive because it is done through the mouth rather than
through a cut in the neck.
The surgeon passes an endoscope with a microscope down the throat and positions the
laser on the tissue to be treated.
Laser surgery uses a narrow, intense beam of light to remove the cancer. It helps preserve
laryngeal tissue so the person can speak, swallow and breathe as normally as possible.
C02 laser endoscopy has been also used for the management of benign or malignant
tumours in the oral cavity or pharynx and for nasal surgery.
This method is useful for the management of both benign and malignant tumours.
laryngeal laser surgery setup
Bronchoscopy
A bronchoscope is a device used to see the inside of the airways and lungs. The
scope can be flexible or rigid.
It is a tube less than one half inch (1 centimeter) wide and about 2 feet (60
centimeters) long. In rare cases, a rigid bronchoscope is used.
A rigid bronchoscope is a straight tube. It’s only used to view the larger airways.
It may be used within the bronchi to:
• Remove a large amount of secretions or blood
• Control bleeding
• Remove foreign objects
• Remove diseased tissue (lesions)
 A flexible bronchoscope is used more often. Unlike the rigid scope, it can be
moved down into the smaller airways (bronchioles). The flexible bronchoscope
may be used to:
• Place a breathing tube in the airway to help give oxygen
• Suction out secretions
• Take tissue samples (biopsy)
• Put medicine into the lungs
Photodynamic therapy
• Photodynamic therapy utilizes a photosensitizing drug, hematoporphyrin
derivative, and laser light to diagnose and treat cancer.
• Two or three days after HPD injection, a laser catheter is inserted into the
bronchial tree and delivers Kr laser light (410 nm).
• The fluorescence emitted by bronchial tissue is sent back through an optical fiber
and passes through a red filter that transmits a narrow band of wavelengths at
approximately 630 nm.
• Red luminescence will be observed only if there is a malignant tumor which was
exposed to the Kr laser light.
• The laser catheter provides a preliminary warning of the presence of tumors, but
their exact location can be determined only with fluorescent endoscopy.
Thin and Ultrathin Laser Catheters and Endoscopes
• Thin and ultrathin fiberoptic endoscopes, some of which having a flexible distal
tip. These allow for atraumatic endoscopy of the middle ear, eustachian tube,
paranasal sinuses, and nasal cavity
• The passages in the upper airways (e.g., the nose) the paranasal sinuses and the
nasopharynx are narrow and not easily accessible
• The thin laser catheters and laser endoscopes made it possible to carry out
diagnosis, therapy, and surgery inside these passages.
• Laser pulses sent through suitable fibers can be used to shatter stones in the
salivary glands.
laser catheter for laser surgery inside the nose

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FIBEROPTIC LASER SYSTEMS IN

Otolaryngology is a medical specialty which is focused on the ears, nose, and

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