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Quer-Castells M, Sandoval M, Larrosa F. Blue laser for the exclusive endoscopic transcanal approach to middle ear paraganglioma. Eur Arch Otorhinolaryngol 2024; 281:2041-2045. [PMID: 38334782 PMCID: PMC10942876 DOI: 10.1007/s00405-024-08470-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND The management of glomus tympanicum tumours can be challenging. Blue laser coagulation may improve bleeding control thus facilitating an endoscopic transcanal excision. The objective of this presentation is to illustrate the authors' experience using this novel tool. METHODS Case report of a patient that underwent exclusive endoscopic transcanal blue laser surgery of a class A2 glomus tympanicum tumour in a tertiary referral center. CONCLUSION The present study provides evidence of the safety and efficacy of endoscopic blue laser surgery, for the minimally invasive treatment of early-stage glomus tympanicum tumours.
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Affiliation(s)
- Mireia Quer-Castells
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Clinic de Barcelona, C Villarroel 170, 08036, Barcelona, Spain
| | - Marta Sandoval
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Clinic de Barcelona, C Villarroel 170, 08036, Barcelona, Spain
- University of Barcelona Medical School, C Villarroel 170, 08036, Barcelona, Spain
| | - Francisco Larrosa
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Clinic de Barcelona, C Villarroel 170, 08036, Barcelona, Spain.
- University of Barcelona Medical School, C Villarroel 170, 08036, Barcelona, Spain.
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2
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Meisgeier A, Heymann P, Ziebart T, Braun A, Neff A. Wound healing after therapy of oral potentially malignant disorders with a 445-nm semiconductor laser: a randomized clinical trial. Clin Oral Investig 2023; 28:26. [PMID: 38147181 PMCID: PMC10751250 DOI: 10.1007/s00784-023-05438-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/18/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES Oral potentially malignant disorders (OPMDs) are the most clinically relevant precursor lesions of the oral squamous cell carcinoma (OSCC). OSCC is one of the 15 most common cancers worldwide. OSCC is with its high rate of mortality an important cause of death worldwide. The diagnosis and therapy of clinically relevant precursor lesions of the OSCC is one of the main parts of prevention of this malignant disease. Targeted therapy is one of the main challenges concerning an oncologically safe tissue removal without overwhelming functional and aesthetic impairment. MATERIALS AND METHODS In this randomized controlled trial, a newly introduced intraoral 445-nm semiconductor laser (2W; cw-mode; SIROLaser Blue, Dentsply Sirona, Bensheim, Germany) was used in the therapy of OPMDs. Duration and course of wound healing, pain, and scar tissue formation were compared to classical cold blade removal with primary suture by measuring remaining wound area, tissue colorimetry, and visual analogue scale. The study includes 40 patients randomized using a random spreadsheet sequence in two groups (n1 = 20; n2 = 20). RESULTS This comparative analysis revealed a significantly reduced remaining wound area after 1, 2, and 4 weeks in the laser group compared to the cold blade group (p < 0.05). In the laser group, a significantly reduced postoperative pain after 1 week was measured (p < 0.05). CONCLUSION Laser coagulation of OPMDs with the investigated 445-nm semiconductor laser is a safe, gentle, and predictable surgical procedure with beneficial wound healing and reduced postoperative discomfort. CLINICAL RELEVANCE Compared to the more invasive and bloody cold blade removal with scalpel, the 445-nm semiconductor laser could be a new functional less traumatic tool in the therapy of OPMDs. The method should be further investigated with regard to the identification of further possible indications. TRAIL REGISTRATION German Clinical Trials Register No: DRKS00032626.
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Affiliation(s)
- Axel Meisgeier
- Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, Giessen/Marburg, Germany.
- Faculty of Medicine, Philipps-University, Marburg, 35043, Marburg, Germany.
| | - Paul Heymann
- Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, Giessen/Marburg, Germany
- Faculty of Medicine, Philipps-University, Marburg, 35043, Marburg, Germany
| | - Thomas Ziebart
- Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, Giessen/Marburg, Germany
- Faculty of Medicine, Philipps-University, Marburg, 35043, Marburg, Germany
| | - Andreas Braun
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH University Aachen, Aachen, Germany
| | - Andreas Neff
- Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg, Giessen/Marburg, Germany
- Faculty of Medicine, Philipps-University, Marburg, 35043, Marburg, Germany
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Tenore G, Mohsen A, Nuvoli A, Palaia G, Rocchetti F, Di Gioia CRT, Cicconetti A, Romeo U, Del Vecchio A. The Impact of Laser Thermal Effect on Histological Evaluation of Oral Soft Tissue Biopsy: Systematic Review. Dent J (Basel) 2023; 11. [PMID: 36826173 DOI: 10.3390/dj11020028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
The aim of the study is to review the literature to observe studies that evaluate the extent of the thermal effect of different laser wavelengths on the histological evaluation of oral soft tissue biopsies. An electronic search for published studies was performed on the PubMed and Scopus databases between July 2020 and November 2022. After the selection process, all the included studies were subjected to quality assessment and data extraction processes. A total of 28 studies met the eligibility criteria. The most studied laser was the carbon dioxide (CO2) laser, followed by the diode laser 940 nm-980 nm. Six studies were focused on each of the Erbium-doped Yttrium Aluminium Garnet (Er:YAG), Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) lasers, and diode lasers of 808 nm and 445 nm. Three studies were for the Potassium Titanyl Phosphate (KTP) laser, and four studies were for the Erbium, Chromium-doped Yttrium, Scandium, Gallium, and Garnet (Er,Cr:YSGG) laser. The quality and bias assessment revealed that almost all the animal studies were at a low risk of bias (RoB) in the considered domains of the used assessment tool except the allocation concealment domain in the selection bias and the blinding domain in the performance bias, where these domains were awarded an unclear or high score in almost all the included animal studies. For clinical studies, the range of the total RoB score in the comparative studies was 14 to 23, while in the non-comparative studies, it was 11 to 15. Almost all the studies concluded that the thermal effect of different laser wavelengths did not hinder the histological diagnosis. This literature review showed some observations. The thermal effect occurred with different wavelengths and parameters and what should be done is to minimize it by better adjusting the laser parameters. The extension of margins during the collection of laser oral biopsies and the use of laser only in non-suspicious lesions are recommended because of the difficulty of the histopathologist to assess the extension and grade of dysplasia at the surgical margins. The comparison of the thermal effect between different studies was impossible due to the presence of methodological heterogeneity.
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Liu G, Jiang D, Ren M, Lu X, Chang Y, He S, Ren Z, Fan H, Wu K, He D. High‐power 450 nm blue diode laser for endoscopic mucosal resection/endoscopic submucosal dissection in the stomach: Preliminary results on a porcine model with a modified flexible endoscope. Lasers Surg Med Suppl 2022; 54:1002-1009. [PMID: 35870192 DOI: 10.1002/lsm.23561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Guoxiong Liu
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
- Department of Urology Xianyang Central Hospital Xianyang P.R. China
| | - Dali Jiang
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Mudan Ren
- Department of Gastroenterology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Xinlan Lu
- Department of Gastroenterology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Ying Chang
- Department of Gastroenterology Zhongnan Hospital of Wuhan University Wuhan P.R. China
| | - Shuixiang He
- Department of Gastroenterology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Zejun Ren
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Hengtong Fan
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Kaijie Wu
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
| | - Dalin He
- Department of Urology First Affiliated Hospital of Xi'an Jiaotong University Xi'an P.R. China
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Besegato JF, de Melo PBG, Tamae PE, Alves APAR, Rondón LF, Leanse LG, Dos Anjos C, Casarin HH, Chinelatti MA, Faria G, Dai T, Bagnato VS, Rastelli ANDS. How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2? Photodiagnosis Photodyn Ther 2021; 37:102682. [PMID: 34910994 PMCID: PMC8666148 DOI: 10.1016/j.pdpdt.2021.102682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/30/2021] [Accepted: 12/10/2021] [Indexed: 12/23/2022]
Abstract
Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.
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Affiliation(s)
- João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Priscila Borges Gobbo de Melo
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Patrícia Eriko Tamae
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Ana Paula Aparecida Raimundo Alves
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Luis Felipe Rondón
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Leon G Leanse
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Carolina Dos Anjos
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Heitor Hussni Casarin
- Dentistry School, Central Paulista University Center - UNICEP, São Carlos 13563-470, SP, Brazil
| | | | - Gisele Faria
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | | | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
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Fornaini C, Fekrazad R, Rocca JP, Zhang S, Merigo E. Use of Blue and Blue-Violet Lasers in Dentistry: A Narrative Review. J Lasers Med Sci 2021; 12:e31. [PMID: 34733754 DOI: 10.34172/jlms.2021.31] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 12/06/2020] [Indexed: 01/19/2023]
Abstract
Introduction: Blue and blue-violet diode lasers (450 and 405 nm) seem to represent an interesting approach for several clinical treatments today. The aim of this narrative review is to describe and comment on the literature regarding the utilization of blue and blue-violet lasers in dentistry. Methods: A search for "blue laser AND dentistry" was conducted using the PubMed database, and all the papers referring to this topic, ranging from 1990 to April 2020, were analyzed in the review. All the original in vivo and in vitro studies using 450 nm or 405 nm lasers were included in this study. All the articles on the LED light, laser wavelengths other than 405 and 450 nm and using lasers in specialties other than dentistry, as well as case reports, guideline papers and reviews were excluded. Results: From a total of 519 results, 47 articles met the inclusion criteria and were divided into 8 groups based on their fields of application: disinfection (10), photobiomodulation (PBM) (4), bleaching (1), resin curing (20), surgery (7), periodontics (1), endodontics (1) and orthodontics (3). Conclusion: Blue and blue-violet diode lasers may represent new and effective devices to be used in a large number of applications in dentistry, even if further studies will be necessary to fully clarify the potentialities of these laser wavelengths.
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Affiliation(s)
- Carlo Fornaini
- Laboratoire MICORALIS (MICrobiologie ORALe, Immunothérapie et Santé) EA7354, Université Nice Sophia Antipolis, UFR Odontologie, Avenue des Diables Bleus, 06000 Nice, France.,Group of Applied Electro Magnetics (GAEM), Department of Engineering and Architecture, University of Parma, Viale G. P. Usberti 181/A -43124 -Parma, Italy.,2nd Hospital Shijiazhuang, Dept. of Stomatology, 53 Huaxi Road, Shijiazhuang 050051, China
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Jean-Paul Rocca
- Laboratoire MICORALIS (MICrobiologie ORALe, Immunothérapie et Santé) EA7354, Université Nice Sophia Antipolis, UFR Odontologie, Avenue des Diables Bleus, 06000 Nice, France.,2nd Hospital Shijiazhuang, Dept. of Stomatology, 53 Huaxi Road, Shijiazhuang 050051, China
| | - Shiying Zhang
- 2nd Hospital Shijiazhuang, Dept. of Stomatology, 53 Huaxi Road, Shijiazhuang 050051, China
| | - Elisabetta Merigo
- Laboratoire MICORALIS (MICrobiologie ORALe, Immunothérapie et Santé) EA7354, Université Nice Sophia Antipolis, UFR Odontologie, Avenue des Diables Bleus, 06000 Nice, France.,2nd Hospital Shijiazhuang, Dept. of Stomatology, 53 Huaxi Road, Shijiazhuang 050051, China
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Parker S, Anagnostaki E, Mylona V, Cronshaw M, Lynch E, Grootveld M. Systematic Review of Post-Surgical Laser-Assisted Oral Soft Tissue Outcomes Using Surgical Wavelengths Outside the 650-1350 nm Optical Window. Photobiomodul Photomed Laser Surg 2020; 38:591-606. [PMID: 33026973 DOI: 10.1089/photob.2020.4847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To explore via systematic review the validation of uneventful post-surgical healing, associated with shorter and longer laser wavelength applications in minor oral surgery procedures. Methods: From April 28 to May 11, 2020, PubMed, Cochrane Database of Systemic Reviews, and Google Scholar search engines were applied to identify human clinical trials of photobiomodulation (PBM) therapy in clinical dentistry. The searches were carried out with reference to (1) dental laser wavelengths shorter than 650 nm; (2) wavelengths localized within the 2780-2940 nm; and (3) the 9300-10,600 nm range. Selected articles were further assessed by three independent reviewers for strict compliance with PRISMA guidelines and modified Cochrane Risk of Bias to determine eligibility. Results: Using selection filters of randomized clinical trials, moderate/low risk of bias, and the applied period, and following PRISMA guidelines, 25 articles were selected and examined. A risk of bias was completed, where 11 out of 25 publications were classified as low risk of bias, and 14 out of 25 were classified as medium risk status. In total, 6 out of 13 (46% of) studies comparing the examined laser wavelengths with scalpel-based treatment showed positive results, whereas 6 out of 13 (46%) showed no difference, and only 1 out of 13 (7.7%) presented a negative outcome. In addition, 5 out of 6 (83% of) studies comparing the examined laser wavelengths with other diodes (808-980 nm) showed positive results, whereas 1 out of 6 (17%) had negative outcomes. Conclusions: A detailed and blinded examination of published studies has been undertaken, applying strict criteria to demonstrate research outcome data, which suggests positive or at worst neutral comparatives when a given laser wavelength system is used against an alternative control therapy. As such, substantiated evidence for laser surgery in delivering uneventful healing and analgesic effects, as an expression of a PBM-like (quasi-PBM) influence, has been shown.
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Affiliation(s)
- Steven Parker
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Eugenia Anagnostaki
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Valina Mylona
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom
| | - Mark Cronshaw
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom.,School of Dentistry, College of Medical and Dental Sciences, Birmingham University, Birmingham, United Kingdom
| | - Edward Lynch
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom.,School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
| | - Martin Grootveld
- School of Pharmacy, Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom.,School of Dental Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA
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Becker B, Enikeev D, Netsch C, Gross AJ, Laukhtina E, Glybochko P, Rapoport L, Herrmann TR, Taratkin M. Comparative Analysis of Vaporization and Coagulation Properties of a Hybrid Laser (Combination of a Thulium and Blue Diode Laser) Vs Thulium and Ho:YAG Lasers: Potential Applications in Endoscopic Enucleation of the Prostate. J Endourol 2020; 34:862-867. [DOI: 10.1089/end.2020.0009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Benedikt Becker
- Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Andreas J. Gross
- Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany
| | - Ekaterina Laukhtina
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Petr Glybochko
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | | | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
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Limongelli L, Capodiferro S, Tempesta A, Sportelli P, Dell'Olio F, Angelelli G, Maiorano E, Favia G. Early tongue carcinomas (clinical stage I and II): echo-guided three-dimensional diode laser mini-invasive surgery with evaluation of histological prognostic parameters. A study of 85 cases with prolonged follow-up. Lasers Med Sci 2020; 35:751-8. [PMID: 31834561 DOI: 10.1007/s10103-019-02932-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 11/27/2019] [Indexed: 12/15/2022]
Abstract
The management of patients with early stage (cT1-T2) tongue squamous cell carcinoma without clinicoradiologic evidence of neck node metastasis (cN0) has been widely debated over the last 3 decades and still remains controversial. Nevertheless, the identification of patients with low-stage tumours at high-risk for occult cervical metastases is imperative before planning treatments of primary tumours, as well as that of prognostic markers which may possibly select those patients who may benefit of additional workup after surgery in view of the high metastatic potential of the primary tumour. The pre-surgical evaluation of tongue malignant primary tumour (for assessing lateral and deep margins) along with diode laser surgery (with accurate incision, bleeding-free and with reduced/absent post-surgical complications) may lead to a more conservative but equally decisive surgical treatment, also with a greater patient compliance. We studied 85 consecutive cases of cT1-T2 N0 tongue squamous cell carcinoma who had been managed by the following diagnostic/therapeutic protocol: pre-operative high definition ultrasound examination for the evaluation of size and depth, followed by three-dimensional surgical excision by diode laser (wavelength of 800 ± 10 nm, output power of 8 W in continuous wave, flexible optic fibre of 320 μm in contact mode) and detailed histological analyses of well-established prognostic parameters (tumour grade, thickness, depth, front of infiltration and surgical margins) with statistical analysis. No post-surgical photobiomodulation was performed. Overall, 58.82% of patients were stage I, 18% stage II, and the most frequent histotype was squamous cell carcinoma (97.64%). Large nests invasion pattern was observed in 64 cases, expansive pattern in 9, invasion in single cells in 12; front of invasion involved the muscle in 62 cases, vessels in 6, nerves in 15; peritumoural vascular invasion was assessed in 6 patients and perineural invasion in 15. Selective neck lymphadenectomy was performed in 9 cases, and clinically occult node metastases were detected in two cases. At follow-up, 78 patients (98.73%) were alive and free of disease, one patient experienced tumour-related death, while the remaining 6 died for non-disease-related causes. All the histological prognostic parameters were statistically significant (χ2 test; p = 0.05), thus leading to a prognostic weight classification with a three-tiered stratification. On the bases of these results, the authors maintain that the reported diagnostic/therapeutic protocol, including the pre-operative echo-guided three-dimensional evaluation, the following diode laser mini-invasive surgery for tumour excision and the histological examination along with the proposed three-tiered stratification of histological prognostic parameters may allow proper management of clinical stage I and II early tongue carcinomas.
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10
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Palaia G, Impellizzeri A, Tenore G, Caporali F, Visca P, Del Vecchio A, Galluccio G, Polimeni A, Romeo U. Ex vivo histological analysis of the thermal effects created by a 445-nm diode laser in oral soft tissue biopsy. Clin Oral Investig 2019; 24:2645-2652. [PMID: 31734792 DOI: 10.1007/s00784-019-03123-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 10/14/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate, ex vivo, the histological effects of 445-nm diode laser (Eltech K-Laser srl, Treviso, Italy), during an oral soft tissue biopsy. MATERIALS AND METHODS Thirty samples from pig cadaver tongues were obtained, through five laser settings, in continuous and pulsed wave (CW and PW). Samples were divided into six groups of five pieces each. A control specimen was taken by a scalpel. All samples were examined with an optical microscope by a blinded pathologist. Thermal effects on epithelium and connective tissues were measured with LAS 4.8 software. Finally, a statistical evaluation was made using GraphPadPrism 7.0 software. RESULTS All specimens, except one, showed a damage lower than 1 mm. Readability was always optimal; there was a different thermal effect between epithelial and connective tissue and in CW and PW samples, confirmed by statistical analysis too. CONCLUSIONS A 445-nm diode laser creates a minimum thermal effect, that has no implications in the histological evaluation of benign lesions. In suspicious lesions, a safety margin of 1 mm, compared with a scalpel, is preferable. CLINICAL RELEVANCE A 445-nm diode laser has excellent surgical properties and can manage many arduous clinical cases, such as vascularized lesions. In the excision of suspected lesions, it is necessary to compare, case by case, clinical advantages to possible histological implications.
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Affiliation(s)
- Gaspare Palaia
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy.
| | - Alessandra Impellizzeri
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Gianluca Tenore
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Federico Caporali
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Paolo Visca
- Department of Cytology and Cellular Diagnostics, Regina Elena Institute, Rome, Italy
| | - Alessandro Del Vecchio
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Gabriella Galluccio
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
| | - Umberto Romeo
- Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Via Caserta 6, Rome, Italy
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Xu X, Jiang DL, Liu GX, Wu K, Fan J, Wu D, Li L, Wang X, Guo P, Mu L, Qiao X, He D. A Novel 450 nm Semiconductor Blue Laser System for Application in Colon Endoscopic Surgery: An Ex Vivo Study of Laser–Tissue Interactions. Photobiomodulation, Photomedicine, and Laser Surgery 2019; 37:25-30. [PMID: 31050941 DOI: 10.1089/photob.2018.4531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Xiaofeng Xu
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
- Department of Urology, Xianyang Central Hospital, Xianyang, P.R. China
| | - Da-Li Jiang
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
- Department of Urology, Second Affiliated Hospital of Jiamusi University, Jiamusi, P.R. China
| | - Guo-Xiong Liu
- Department of Urology, Xianyang Central Hospital, Xianyang, P.R. China
| | - Kaijie Wu
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Jinhai Fan
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Dapeng Wu
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Lei Li
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Xinyang Wang
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Peng Guo
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Liyue Mu
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
| | - Ximin Qiao
- Department of Urology, Xianyang Central Hospital, Xianyang, P.R. China
| | - Dalin He
- Department of Urology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China
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