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Upper gastrointestinal malignancy: palliation with thermal laser, photodynamic therapy and argon beamer
Published in David Westaby, Martin Lombard, Therapeutic Gastrointestinal Endoscopy A problem-oriented approach, 2019
Since the early 1980s the primary use of thermal lasers has been in the palliation of upper and lower gastrointestinal malignancies. It has become apparent however, that for selected patients with small, non-invasive cancers, the laser can be applied as primary therapy, particularly when surgery is hazardous because of the patient’s general condition. Thermal laser treatment of oesophageal malignancy can be applied using the high-power neodymium–yttrium–aluminium–garnet (Nd-YAG) or gallium–aluminium–arsenide (GaAlAs) diode lasers which have been demonstrated to be effective, relatively safe and easy to apply with the patient under conscious intravenous (iv) sedation. The potassium–titanyl–phosphate (KTP) laser with an operative wavelength of 532 nm has a very superficial depth of penetration, and is useful only to coagulate or cauterize a bleeding surface, although it is used primarily as a cutting instrument and in conjunction with the Nd-YAG laser. The depth of penetration of the laser beam depends on absorption by water and relates to the wavelength of light used (Fig. 4.4).
Outpatient Laryngeal Procedures
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
The most commonly used angiolytic laser today in laryngology is the 532 nm potassium titanyl phosphate (KTP) laser. The absorbance of haemoglobin has peaks at approximately 541 nm and 577 nm,20 allowing the KTP laser energy to be absorbed into the pathology, such as papilloma or dysplasia, with no collateral injury to surrounding normal tissue (Figure 79.3). The angiolytic parameters of the KTP laser were studied in the avian chorioallantoic membrane indicating that 35 watts, 15 millisecond pulse width and 2 pulses per second achieved ideal photoablation without surrounding collateral damage. Figure 79.4a shows the typical avian chorioallantoic membrane model with its vasculature. Figure 79.4b is demonstrating ablation of a single 100 micron vessel without vessel rupture or collateral damage.20 Findings of this study translated seamlessly to the vocal fold mucosa and remains the author’s most frequently used KTP laser settings. In the delicate and highly specialized layered microstructure of the vocal fold, maximal preservation of normal tissue surrounding a lesion is critical to minimizing any vocal deficit.
Adult Anaesthesia
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Daphne A. Varveris, Neil G. Smart
The neodymium-doped yttrium-aluminium-garnet (Nd:Yag) laser was introduced in the 1980s and penetrates tissue more deeply than the CO2 laser. It can also be delivered by means of a flexible fibre-optic light cable that can be used in conjunction with a fibre-optic bronchoscope to treat lesions in the trachea and bronchi. The potassium titanyl phosphate (KTP) laser is a variant of the Nd:Yag, in which the laser beam is passed through a potassium titanyl phosphate crystal.
Efficacy and safety of lasers in treating syringomas: a review of the literature
Published in Journal of Dermatological Treatment, 2022
Huang et al. carried out a retrospective study of 18 Taiwanese women (median age 29.5 years) with a histopathological diagnosis of vulvar syringoma during the past 10 years at their clinic. CO2 laser vaporization emerged as an effective therapeutic modality in resolving the lesions and intense pruritus and relieved for 9 months of follow-up in 7 patients (31). A 577 nm pro-yellow laser in a continuous wave mode was used for the treatment of vulvar syringoma in a 42-year-old woman with a disease history of 24 years. The 577 nm pro-yellow laser was used at 4 weeks intervals which resulted in the complete disappearance of lesions with no complaints of pruritus in 2 sessions. No side effects were reported (32). A 35-year-old lady from Turkey suffering from vulvar syringoma was treated with laser vaporization. No recurrence was reported after the first-month follow-up and the patient was satisfied with the treatment (33). In a Korean woman suffering from vulvar syringoma associated with pruritis, super pulse CO2 laser ablation and 50% trichloroacetic acid (TCA) chemical peeling followed by topical application of fusidic acid and Juango resulted in complete clearance with no subjective symptoms of pruritus after 8 weeks. Mild post-inflammatory hyperpigmentation was noticed (34). In a case report by Gerdsen et al., a German woman was suffering from vulvar syringoma and infraorbital syringomas with a milia-like appearance. Potassium-titanyl-phosphate 532 nm laser treatment was successful in treating the infraorbital lesions but failed to improve vulvar lesions (35).
Prostatic dystrophic calcification following salvage cryotherapy for prostate cancer – an under-reported entity?
Published in Scandinavian Journal of Urology, 2021
Arnon Lavi, Shiva M. Nair, Daniel Halstuch, Joseph L. Chin
Prior reports of dystrophic calcification of the prostate are scarce. Dru and Bender [9] reported the only reported case of DC following primary hemi-ablation cryotherapy. Though not reported specifically, this patient apparently also developed clinically obstructing DC as a late event following his cryotherapy. The case was managed with a transurethral resection of the prostate (TURP) with complete resolution. Jones et al. [10] reported on three patients with prostate cancer who developed DC after TURP followed by radiotherapy, suggesting radiotherapy plays a significant role in the pathogenesis process. Two other cases of DC formation in the prostate have been reported following non-cancer prostate manipulations. Zumstein et al. [11] reported on recurrent DC following simple TURP. Jeon et al. [12] reported DC after potassium-titanyl phosphate (KTP) laser vaporization of the prostate. In both reports, the interval between the procedure and occurrence of DC was relatively short, possibly suggesting different pathogenesis. DC may occur in other clinical scenarios, including vascular disease, collagen deposition disease, other rheumatologic diseases, post-radiation therapy and post-traumatic situations [13–15]. One proposed mechanism for DC is the calcification resulting from chronic inflammation and necrosis [13].
Comparative efficacy of short-pulsed intense pulsed light and pulsed dye laser to treat rosacea
Published in Journal of Cosmetic and Laser Therapy, 2019
Bo Young Kim, Hye-Rim Moon, Hwa Jung Ryu
There are many treatment options for rosacea; topical and oral medications are available, such as topical metronidazole, azelaic acid cream, and nonirritating benzoyl peroxide. Systemic oral antibiotics including tetracyclines, doxycycline, and minocycline has been used with success. However, there are increasing needs for other safe treatment options because of antibiotic resistance and irritation after use of topical treatments (2). Laser and light-based therapies, including pulsed dye laser (9), intense pulsed light (10), potassium titanyl phosphate (KTP) (11), and radiofrequency (12) have been reported to be effective in treating erythema and telangiectasia of rosacea.