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October 1995

The Holmium:YAG Laser-Assisted Otolaryngologic Procedures

Author Affiliations

From the Department of Otolaryngology—Head and Neck Surgery and the Eleanor Naylor Dana Laser Research Laboratory, Lahey Clinic, Burlington, Mass. Dr Gleich is now with the Department of Otolaryngology, University of Cincinnati (Ohio) Medical Center. Drs Rebeiz and Shapshay and Mr Pankratov are now with the Department of Otolaryngology—Head and Neck Surgery, New England Medical Center, Tufts University School of Medicine, Boston, Mass.

Arch Otolaryngol Head Neck Surg. 1995;121(10):1162-1166. doi:10.1001/archotol.1995.01890100070012

Objective:  To determine the effectiveness of the holmium: YAG (Ho:YAG) laser in otolaryngologic procedures that necessitate the ablation of osseous and soft tissue.

Design:  Case series.

Setting:  Lahey Clinic, Burlington, Mass.

Patients:  Consecutive series of 37 patients; 29 with chronic sinusitis, five with chronic dacryocystitis, one with recurrent choanal stenosis, one with tracheopathia osteoplastica, and one with a sphenoid sinus mucocele.

Intervention:  The Ho:YAG laser was used to assist in 37 procedures, including endoscopic sinus surgery, dacryocystorhinostomy, treatment of choanal stenosis, ablation of obstructive tracheopathia osteoplastica, and removal of a sphenoid sinus mucocele.

Main Outcome Measures:  Postsurgical success and complications, satisfaction of the patients, and the abiliity of the laser to remove tissue.

Results:  Complications occurred in eight patients: intranasal or ethmoid scarring (four), persistent polyps (one), bleeding (one), stent dislodgment (one), and tracheitis (one). Three patients required revision surgery. None of the complications were related to use of the laser, although the laser may produce increased scarring. The laser was effective for osseous and soft-tissue ablation, but its usefulness was limited for hemostasis.

Conclusions:  The Ho:YAG laser can be used in otolaryngologic procedures when surgical access is difficult or when controlled, precise ablation of osseous tissue is necessary.(Arch Otolaryngol Head Neck Surg. 1995;121:1162-1166)

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