Use of the KTP‐532 Laser in Acoustic Neuroma Surgery

Nissen, Alan J.; Sikand, Ashley; Welsh, Joseph E.; Curto, Frank S.

doi:10.1097/00005537-199701000-00022

Cited by 11 publications

(11 citation statements)

References 9 publications

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“…The adherence of the tumor shell to the nerve itself and, tumor size and form usually determine the intensity of mechanical manipulation during dissection of tumor. Our 6 month follow up results for facial nerve preservation was similar and comparable to other reports [4,7,33,39,41,[43][44][45]. Therefore, the use of the laser in proximity of the nerve seems to be safe enough and is recommended especially when having a direct view of the facial nerve such as in the RS approach.…”

Section: Discussionsupporting

confidence: 89%

“…On the contrary, on study described a slightly worse outcome with this technic [42]. The normal facial function has been reported in 90% in tumors smaller than 1.5 cm [41].…”

Section: Discussionmentioning

confidence: 83%

“…VS surgery by hand-held laser assistance has been described in several studies with no agreement between them about its benefit and weak points [19,40,41]. Some of them recommended it for patients with larger tumors [19,40].…”

Section: Discussionmentioning

confidence: 99%

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Vestibular Schwannomas Microsurgery Assisted by Flexible Hand-Held 2 micro-Thulium-Fiber Laser

Mastronardi

Cacciotti

Roperto

et al. 2016

Caspian.J.Neurol.Sci

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Background: Vestibular Schwannoma (VS) is one of the skull base tumors originating from vestibular portion of eighth cranial nerve. Recently, 2 microThulium laser is used in the surgery of some intracranial tumors. Objectives: Assessing the efficacy of 2 micro-Thulium flexible hand-held laser fiber (Revolixjr ® ) in microsurgical removal of VS. Materials and Methods:This retrospective non-randomized study was carried out from July 2012 to November 2015. 39 patients with VS had been operated on with microsurgical technique via retro-sigmoid approach. 2 micro-Thuliumfiber hand-held flexible laser was used for tumor resection in 39 cases. Facial nerves function by House-Brackmann (HB) scale and hearing state were assessed preoperatively and 1 week and 6-month postoperatively. Results: Overall time of surgery changed only in proportion with the size of tumor (185-575 minutes) and was not affected by the use of laser. In 5out of 39cases, preoperative facial nerve palsy HB2, and in one case HB4 (permanent) was observed. On considering 38 cases, at 6-month follow-up facial nerve preservation rate (HB1) was 92.1% (from May 2015 all patients had not postoperative facial palsy). Hearing preservation rate was possible in 12 out of 15 cases with previously acceptable preoperative hearing state (AAO-HNS A and B classes). The mean surgeon satisfaction rate of usefulness of this technic was 2.7 in a 0-3-scale Conclusions: A good functional outcome including facial nerve preservation and hearing preservation was obtained by micro-Thulium-fiber hand-held flexible laser microsurgery.

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Section: Discussionsupporting

confidence: 89%

“…On the contrary, on study described a slightly worse outcome with this technic [42]. The normal facial function has been reported in 90% in tumors smaller than 1.5 cm [41].…”

Section: Discussionmentioning

confidence: 83%

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Vestibular Schwannomas Microsurgery Assisted by Flexible Hand-Held 2 micro-Thulium-Fiber Laser

Mastronardi

Cacciotti

Roperto

et al. 2016

Caspian.J.Neurol.Sci

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“…The CO 2 laser seems to be ideal for neuro-otologic surgery due to its precise application and minimal depth of penetration [7]. However, the CO 2 laser beam can only be directed in a straight line towards the tumor, hence KTP lasers have been favored by some authors as the energy can be applied through a flexible endoscope or curved handpiece [8].…”

Section: Introductionmentioning

confidence: 99%

Use of flexible CO2 laser fiber in microsurgery for vestibular schwannoma via the middle cranial fossa approach

Scheich

Ginzkey

Harnisch

et al. 2011

Eur Arch Otorhinolaryngol

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The aim of this study was to analyze the results of microsurgery in vestibular schwannomas (VS) with assistance of a flexible CO(2) laser fiber (Omniguide(®)) using the middle cranial fossa (MCF) approach. For that purpose we performed a prospective non-randomized clinical trial. In 20 consecutive patients suffering from VS and elected for microsurgery via the MCF approach, tumor resection was performed with the aid of the flexible CO(2) laser ("laser group", LG). Twenty patients with similar tumor volume and pre-operative hearing status out of a cohort of 76 patients previously treated by the same surgeon without laser were used as comparison group ("conventional group", CG) (matched-pair-technique). Facial weakness (House-Brackmann (HB) 2-4) was seen in early postoperative (p.o.) days in six patients in each group and all recovered completely by 3 months p.o., except one patient with HB 2 in CG. Facial nerve preservation rate (HB 1 + 2) was 100% in both groups. Hearing preservation rate (Gardner/Robertson class 1 + 2 or AAO-HNS A + B, pre- and postoperatively) was 72% in LG and 82% in CG, without significant difference. Overall time from incision to skin suture was 157 min (SD 55.9) in CG and 160 min (SD 39.7) in LG. Tumor preparation time was 23.2 min (SD 19.7) in CG and 36.1 min (SD 33.8) in LG. The use of a handheld flexible CO(2) laser fiber in VS-microsurgery is safe and subjectively facilitates tumor resection especially in "difficult" (e.g., highly vascularized) tumors. However, in this limited prospective trial the excellent functional outcome following conventional microsurgery could not be further improved, nor the surgical time reduced by means of the non-contact laser-tool. Focusing the use of the flexible CO(2) laser on "difficult" tumors may lead to different results in future.

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“…The advantages of KTP laser dissection in the surgical treatment of acoustic neuromas have also been well documented [10]. The KTP laser allows for small developmental and vascular tumours to be safely excised from the middle ear [11,12].…”

Section: Introductionmentioning

confidence: 98%

KTP-532-Laser-Assisted Tympanoplasty

Gerlinger¹,

Pytel²

2001

Otorhinolaryngol Nova

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Objectives: The aim of this paper was to give a general review on appropriate applications (cutting, vaporization, coagulation) of the KTP laser in chronic ear surgery. Patients: Between December 1997 and December 2000, 46 laser-assisted tympanoplasties were carried out by the first author. Out of the 46 patients, 29 were female and 17 were male. The patients ranged in age from 4 to 66 years with a median of 32.5 years. Methods: The power of the laser applied was between 1 and 3 W, usually being 2 W. The mode of the application was either continuous or pulsing. In case of the latter mode, the length of the pulse was generally 0.2 s. The laser light was directed to the microscopic field with a flexible fiber scope by means of a hand-held probe. The diameter of the fiber scope was 0.2 mm. Results: Of the 32 patients who underwent combined-approach tympanoplasties, 19 had already undergone a second-look procedure. Residual cholesteatoma pearls were found in 2 cases (10%). The remaining 14 patients underwent laser-assisted myringoplasties. Neither facial palsy nor sensorineural hearing loss occurred. No postoperative infection or vertigo was noted. Five patients experienced moderate postoperative pain after the third postoperative day. Conclusions: The authors’ impression is that the KTP laser allows excellent haemostasis during chronic ear surgery and enables the surgeon to obtain a more effective disease removal in a bloodless field. Using the laser, cochlear trauma can be avoided.

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Use of the KTP‐532 Laser in Acoustic Neuroma Surgery

Cited by 11 publications

References 9 publications

Vestibular Schwannomas Microsurgery Assisted by Flexible Hand-Held 2 micro-Thulium-Fiber Laser

Vestibular Schwannomas Microsurgery Assisted by Flexible Hand-Held 2 micro-Thulium-Fiber Laser

Use of flexible CO2 laser fiber in microsurgery for vestibular schwannoma via the middle cranial fossa approach

KTP-532-Laser-Assisted Tympanoplasty

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