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December 1996

Mucosal Intact Laser Tonsillar Ablation

Author Affiliations

From the Division of Pediatric Otolaryngology, Otolaryngology Research Center for Advanced Endoscopic Applications, Department of Otolaryngology—Head and Neck Surgery, New England Medical Center and Tufts University School of Medicine, Boston, Mass.

Arch Otolaryngol Head Neck Surg. 1996;122(12):1355-1359. doi:10.1001/archotol.1996.01890240061013

Background:  A laser technique has been developed in the laboratory using a noncontact 810-nm diode laser.

Results:  Mucosal intact laser tonsillar ablation (MILTA) coagulates tonsillar lymphoid tissue while preserving the overlying mucosa. A canine model was used to evaluate this new method. The canine tonsils were exposed to laser energy for 5 to 6 minutes each at 8 to 10 W of power. This technique was compared with standard "cold" knife tonsillectomy. The dogs were observed carefully during the postoperative period. When comparing parameters such as onset of eating solid food, amount of food ingested per day, onset of normal activity, and degree of weight loss, MILTA showed significant benefit over the standard technique. The operative sites were evaluated and compared at 1.5 hours and at 7, 21, and 45 days after treatment.

Conclusions:  None of the tonsils treated by MILTA showed mucosal ulceration. At the end of 45 days, histopathological examination showed complete absence of tonsillar tissue with normal mucosa in both the MILTA and standard groups. Traditional tonsillectomy techniques are associated with moderate morbidity and the potential for serious hemorrhage. With the preservation of the overlying mucosa, the possible clinical advantages of this approach to tonsillectomy are the absence of bleeding, avoidance of general anesthesia in older patients, less operating time, and decreased postoperative morbidity. The potential for office treatment exists. Additional laboratory studies, as well as careful clinical trials, are indicated based on these encouraging results.Arch Otolaryngol Head Neck Surg. 1996;122:1355-1359

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