Selection of 1.94 µm Thulium Fiber Laser Parameters for Submucosal Coagulation of the Inferior Turbinates


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Introduction:

Medical treatment often provides only short-term relief and is ineffective in many cases. Surgical interventions for vasomotor rhinitis, while effective, are associated with significant bleeding, nasal tamponade and hospitalization.

Objective:

To determine the optimal parameters for laser treatment using a 1.94 μm wavelength on nasal turbinates in vasomotor rhinitis.

Methods:

The coagulation potential of the 1.94 μm wavelength on calf kidney tissue was investigated to guide the selection of laser parameters for nasal turbinates. Interstitial coagulation was performed on calf kidney tissue at power levels ranging from 1 W to 5 W with a 1 W interval. The fiber movement speed was set at 4 mm per second. Each power level was tested five times for statistical analysis, and ten samples were obtained for histological assessment.

As a result of the research, it was found that with interstitial exposure, the largest area of coagulation is observed at a power of 3 W, and the overall diameter of the impact is on average 2.57 ± 0.1 mm.

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作者简介

Sergey Karpishchenko

Pavlov First Saint Petersburg State Medical University

Email: karpischenkos@mail.ru
ORCID iD: 0000-0003-1124-1937
SPIN 代码: 1254-0263

D. Sc. (medicine), Professor, Head of department of Otorhinolaryngology with Clinic of Pavlov First Saint Petersburg State Medical University

俄罗斯联邦, 197022, Saint Petersburg, Russia. L'va Tolstogo str. 6-8

Marina Ryabova

Pavlov First Saint Petersburg State Medical University

Email: marinaryabova@mail.ru
ORCID iD: 0000-0002-6714-9454
SPIN 代码: 3951-7190

Doctor of Medical Sciences, Professor of the Department of Otorhinolaryngology with clinic of Academician I.P. Pavlov First St. Petersburg State Medical University

俄罗斯联邦, 197022, Saint Petersburg, Russia. L'va Tolstogo str. 6-8

Mikxail Ulupov

Pavlov First Saint Petersburg State Medical University

Email: mike.ulupov@gmail.com
ORCID iD: 0000-0002-8460-9889
SPIN 代码: 1851-8202

Candidate of medical sciences, associate professor of the Department of Otorhinolaryngology with clinic of
Academician I.P. Pavlov First St. Petersburg State Medical
University

俄罗斯联邦, 97022, Saint Petersburg, Russia. L'va Tolstogo str. 6-8

Galina Yukina

Pavlov First Saint Petersburg State Medical University

Email: pipson@inbox.ru
ORCID iD: 0000-0001-8888-4135
SPIN 代码: 2533-2084

Head laboratory of pathomorphology of the scientific and clinical center of pathomorphology 

俄罗斯联邦, 197022, Saint Petersburg, Russia. L'va Tolstogo str. 6-8

Elena Sukhorukova

Pavlov First Saint Petersburg State Medical University

Email: len48@inbox.ru
ORCID iD: 0000-0001-5521-7248
SPIN 代码: 2115-9041

Senior researcher of laboratory of pathomorphology, scientific and clinical center of pathomorphology.

俄罗斯联邦, 197022, Saint Petersburg, Russia. L'va Tolstogo str. 6-8.

Jakhongir Rakhmonov

Pavlov First Saint Petersburg State Medical University

编辑信件的主要联系方式.
Email: janik.27@mail.ru
ORCID iD: 0009-0005-9176-0156

Postgraduate student of the Department of Otorhinolaryngology with clinic of Academician I.P. Pavlov First St. Petersburg State Medical University

俄罗斯联邦, 197022, Saint Petersburg, Russia. L'va Tolstogo str. 6-8

参考

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  4. Karpishchenko S.A., Ryabova M.A., Ulupov M.Y. Laser surgery in otolaryngology at the present stage // Consilium Medicum. - 2014. - Vol. 16. - N. 11. - P. 73-76.
  5. Karpishchenko SA, Riabova MA, Ulupov MYu, Shumilova NA, Portnov GV. The choice of parameters for the laser application in ENT surgery. Vestnik Oto-Rino-Laringologii. 2016;81(4):14 18.
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  7. Kang S. H. et al. Clinical feasibility trial of 1,940-nm diode laser in Korean patients with inferior turbinate hypertrophy //Medical Lasers. – 2015. – Т. 4. – №. 2. – С. 60-64.
  8. Ryabova M.A., Ulupov M.Y., Shumilova N.A. et al.: Possibilities of sparing surgical treatment of vasomotor rhinitis in elderly. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae 2020; 26 (4): pp. 50-58. doi: 10.33848/foliorl23103825-2020-26-4-50-58
  9. Sroka R, Havel M, Betz C, Kremser T, Leunig A. Clinical feasibility trial on 1940 nm Tm: fiber laser intervention of hyperplastic inferior nasal turbinates. Photonics Lasers Med 2012; 1: 215–222.
  10. Anderson M, Liang J. Trends in inferior turbinate surgery: analysis of patients using the Medicare database. Int Forum Allergy Rhinol. 2018 Oct;8(10):1169-1174.
  11. Comparison of cutting and coagulation properties of 1.56 and 1.94 µm fiber lasers and 0.98 µm semiconductor laser Ryabova M.A., Ulupov M.Yu., Shumilova N.A., Portnov G.V., Tikhomirova E.K., Malkova M.E. Bulletin of Siberian Medicine. 2021;20(4):56–62.
  12. Shakhnazarov A.E., Lavrenova G.V., Gaskova P.I. Treatment of vasomotor rhinitis with liquid nitrogen. Folia Otorhinolaryngologiae et Pathologiae Respiratoriae 2022; 28 (2): pp.72-78.
  13. Orhan I, Ayd1n S, Ormeci T, Y1ilmaz F. A Radiological Analysis of Inferior Turbinate in Patients with Deviated Nasal Septum by Using Computed Tomography. American Journal of Rhinology & Allergy. 2014;28(1): e68-e72. doi: 10.2500/ajra.2014.28.4007

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