This document discusses the use of lasers in ear, nose, and throat (ENT) procedures. It provides an overview of different types of lasers used in ENT, including CO2, diode, argon, KTP, and Nd:YAG lasers. It describes the properties and applications of CO2 lasers, which are commonly used for laryngeal, nasal, and oral surgeries. The document outlines several ENT procedures that can be performed using CO2 lasers, such as excision of oral cavity lesions, vocal cord polyps, and nasal septal masses. It notes the advantages of laser ENT procedures include minimal pain, excellent hemostasis, and reduced risk of infection and complications.

1. LASER IN ENT
Dr. HITESH BHOGILAL SHAH
MS ENT
SHRAVAN LASER ENT HOSPITAL
AMRELI
www.shravanhospital.com

2. LASER- LIGHT AMPLIFICATION BY
STIMULATED EMISSION OF RADIATION
 A laser device can generate a high intensity light
that makes laser useful for commercial and medical
applications.
 In 1964,Patel at Bell laboratories developed CO2
laser.
 It emitted spectral energy in the far IR portion of the
electromagnetic spectrum at 10600 nm.
 At this wavelength energy is heavily absorbed by
water, which is the primary constituent in living
tissues ---cutting tissues by vaporisation.

3. TYPES OF LASER
 CO2- laryngeal, nasal and oral surgery
 Diode- tracheal and nasal sx
 Argon – ophthalmology and dermatology
 KTP- stapedotomy
 Nd:YAG – gastric , urology, dermatology.

4. PROPERTIES OF CO2 LASER
 Coherent : all light waves are in same phase
 Monochromatic : just one wavelength and not split
 Unidirectionality

5. APPLICATION TECHNIQUE
 Contact technique-fibre tip touches the tissue
surface.
 Non contact technique- laser probe directed to
target tissue from some distance.
 The pathologies which are easily accessible to the
naked eye can be dealt with using the hand-held
probe like a pen .
 The lesions in the depth--- micromanipulator
atached to the microscope

6. CO2 LASER


7. CONTROL PANEL

8. BEAMS
 Focused beam : highly focused beam-tissue
vaporization-incision
 Defocused beam : wider zone of removal but
shallower depth of penetration as compared to the
focused mode, co2 lasers in laser beam coagulates
and seals blood vessels upto 1mm,providing
bloodless surgical site.

9. CONTINUOUS MODE
 Deeper penetration required
 Lesions of solid consistency
 Excisions of bulky lesions,base of tongue lesions,
partial glossectomy, early ca.vocal cords etc.

10. PULSED MODE
 Benign lesions
 Vocal cord polyp,nodule
 Nasal septal mass
 Pedunculated mass in oropharynx
 Superficial lesions
 Ca in situ

11. SUPER PULSE MODE
 Penetration required is least and beam can be
given in single pulse,repeatedly or continuously.
 Vocal cord cyst, leukoplakia
 Epistaxis
 Premalignant lesions of oral cavity and oropharynx

12. INDICATIONS OF CO2 LASER
 Benign lesions – papillomas, fibromas,
haemangiomas, cysts, polyps
 Premalignant lesions- keratosis, leukoplakia,
melanoplakia and Ca.in situ.
 Malignant lesions-depending on the stage of lesion
 BIOPSY TRICKS

13. ORAL CAVITY AND OROPHARYNX
 Gums
 Lip lesions
 Angle of mouth
 Floor of mouth
 Tongue
 Tonsils
 Palate
 uvula

14. LT BUCCAL POLYP EXCISION

15. LEUKOPLAKIA OF TONGUE

16. HAEMANGIOMA OF TONGUE

17. LEUKOPLAKIA RT ANGLE OF MOUTH

18. LARYNGOPHARYNX AND LARYNX
 Posterior pharyngeal wall
 Epiglottis
 Pyriform fossa
 Arytenoids
 Vocal cords
 Ca larynx
 Subglottic lesions
 Tracheal lesions

19. NOSE AND NASOPHARYNX
 Epistaxis
 Septal mass,polyp,haemangioma
 Synechiae
 Residual pol,yps
 Adnoids
 Choanal atesia

20. EAR
 stapedectomy

21. ADVANTAGES
 Minimal pain
 Excellent haemostasis
 Minimal post-op oedemaminimal post-op care
 Minimal or no changes of post-op infection
 Excellent precision
 Early mobilisation

22. LIMITATIONS
 Cost factor
 Fire hazards
 Special training
 Anaesthetic compications

23. TAKE HOME MESSAGE
 Laser has changed the complete scenario of
surgery with added advantage of minimal blood
loss, excellent haemostasis, improved healing
process, less morbidity and hospitalization and
better post operative results.

24. WWW.SHRAVANHOSPITAL.COM
THANK YOU