gms | German Medical Science

76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

04.05. - 08.05.2005, Erfurt

Nd:YAG laser ablation versus Coblation® in recurrent chronic polypous rhinosinusitis

Meeting Abstract

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno541

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Veröffentlicht: 22. September 2005

© 2005 Ilgner et al.
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Gliederung

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Introduction: While laser resection of recurrent nasal polyps has become an established microinvasive method, the ablation of tissue by „Coblation“®, i.e. by a highly energized electric field has been limited to the reduction of nasal turbinate volume as well as oropharyngeal procedures in Otorhinolaryngology. The motivation for this study was to examine the feasibility of Coblation® for post-operative follow-up procedures in chronic rhinosinusitis with polyps.

Material and methods: In an in-vitro-study we compared the resection properties of a Nd:YAG laser (Dornier® MediLas® 5060N) in cw, contact mode including negative feedback power control („Fibertom“) at 10w, 20w and 30w power with a Coblation® device (ArthroCare® CoblatorII®) via a straight 1,6 mm probe at level 2, 4 and 6 for human nasal polyp tissue.

Results: In laser resection we found that the laser fibre tended to stick to the polyp tissue surface with increasing laser power, while coagulation of deeper tissue layers did not occur. With the Coblation® device, ablative effects were beginning to show at level 4 and were marked at level6, while the resection speed was higher than with laser ablation. In both cases, histology revealed a carbonisation zone of several µm, while coagulation zones extended over more than 100µm width with Coblation® compared to 50-70µm with Nd:YAG laser resection.

Conclusion: Both methods are comparable in terms of ablative properties and running costs for single-use material. The advantage of Coblation® is that laser safety precautions are obsolete while resection speed is higher. However, coagulation zones reach deeper into tissue layers and have to be evaluated in vivo in a follow-up study.