Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Marc Rubinstein & William B. Armstrong
- چاپ و سال / کشور: 2011
Description
Transoral laser microsurgery (TLM) is an emerging technique for themanagement of laryngeal and other head and neck malignancies. It is increasingly being used in place of traditional open surgery because of lower morbidity and improved organ preservation. Since the surgery is performed from the inside working outward as opposed to working from the outside in, there is less damage to the supporting structures that lie external to the tumor. Coupling the laser to a micromanipulator and a microscope allows precise tissue cutting and hemostasis; thereby improving visualization and precise ablation. The basic approach and principles of performing TLM, the devices currently in use, and the associated dosimetry parameters will be discussed. The benefits of using TLM over conventional surgery, common complications and the different settings used depending on the location of the tumorwill also be discussed.Although the CO2 laser is the most versatile and the best-suited laser for TLM applications, a variety of lasers and different parameters are used in the treatment of laryngeal cancer. Improved instrumentation has lead to an increased utilization of TLM by head and neck cancer surgeons and has resulted in improved outcomes. Laser energy levels and spot size are adjusted to vary the precision of cutting and amount of hemostasis obtained.
Lasers Med Sci (2011) 26:113–124 DOI 10.1007/s10103-010-0834-5 Received: 2 December 2009 / Accepted: 13 August 2010 / Published online: 11 September 2010
