Clinical Thermal Effects of Flexible Fiber CO 2 Laser

Abstract

Objective: To date no clinical investigations have reported on the coagulation effects of flexible fiber CO₂ laser delivery to head and neck tissue, the results of which have a direct impact for the progression of transoral laser microsurgery. The objective of the present study was to investigate the histopathologic thermal effects of a flexible fiber CO₂ laser delivery system.

Method: A prospective histopathologic analysis of 15 consecutive transoral laser microsurgery specimens using the same CO₂ fiber system were subjected to dedicated histopathologic analyses. Repeated coagulation depth measurements of 2 independent clinical pathologists were averaged. Specimens were stratified into lymphoid or epitheloid groups for further comparison.

Results: The mean coagulation depth across all specimens was 81.53 um (SD, 38.73; range, 15.00-360.34). Although the mean coagulation depth in lymphoid tissues (mean, 75.38 um; SD, 15.91) was elevated over the mean depth of epitheloid tissues (mean, 90.74 um; SD, 31.21), there was no significant difference (P = .11).

Conclusion: With an average coagulation depth of 81.53 um the flexible fiber thermal effect compares favorably to tissue effect of line-of-sight lasers. Epitheloid and lymphoid tissues displayed equivalent coagulative effects. To our knowledge, this is the first clinical description of flexible CO₂ laser delivery thermal effects of tissues of the head and neck.