Photoangiolytische Laser in der Laryngologie

Mit photoangiolytischen Lasern wie dem KTP (Kalium-Titanyl-Phosphat, 532 nm Wellenlänge) Laser oder dem neuen „blauen“ Laser (445 nm Wellenlänge) können kleinste Gefäße innerhalb der Stimmlippen unter Schonung des darüberliegenden Epithels und der Lamina propria verödet werden. Dadurch kann jetzt noch besser der Forderung Rechnung getragen werden, bei der effektiven Behandlung von pathologischen Gewebeveränderungen wie bspw. bei Papillomen, Ödemen, Polypen, Leukoplakien, Dysplasien und ektatischen Blutgefäßen gleichzeitig die physiologische Schwingungsfähigkeit der Stimmlippe zu bewahren. Da das Laserlicht durch feinste Glasfasern in den Kehlkopf geleitet werden kann, sind schmerzfreie Eingriffe im Behandlungsstuhl mit indirekt transnasal eingeführten flexiblen Optiken (mit Arbeitskanal) wie auch Operationen in Vollnarkose während einer Mikrolaryngoskopie möglich. Ein neuer sog. „blauer“ Laser ermöglicht zusätzlich neben der Koagulation auch das Schneiden von Gewebe, dann meist in Mikrolaryngoskopie.

Abstract

With photoangiolytic lasers like KTP (Potassium-Titanyl-Phosphate, 532 nm) lasers or the new “blue” laser (445 nm), even the smallest vessels and capillaries within the vocal fold can be treated without destroying the covering epithelium. This enables effective treatment of benign and malignant sub- and intraepithelial lesions of the vocal folds such as papilloma, edema, polyps, leukoplakia, dysplasia and capillary vessels while preserving the vibratory properties of the different layers of the lamina propria. Because photoangiolytic laser light can be routed through tiny glass fibers, office-based surgery with channelled flexible endoscopes are feasible as well as phonomicrosurgical operations under general anesthesia. Furthermore, the so called “blue” laser can cut tissues and thus broadens the technical armamentarium of the phonosurgeon.

Fazit

Photoangiolytische Laser eignen sich ganz besonders für phonochirurgische Operationen an den Stimmlippen.

Schlüsselwörter

Photoangiolyse - Phonochirurgie - KTP Laser - blauer Laser - 445 nm Wellenlänge - indirekte Kehlkopfoperationen

Keywords

photoangiolysis - phonosurgery - KTP laser - blue laser - 445 nm wavelength - in-office phonosurgery

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