Contact Diode Laser Research Articles

Comparison between contact diode laser with 980 nm and 1470 nm wavelengths for posterior laryngofissure in pigs

To compare two different wavelengths of the surgical contact diode laser (CDL) for producing a posterior laryngofissure in in-vivo pigs. Anesthetized pigs underwent a tracheostomy and an anterior laryngofissure through a cervicotomy. They were randomly selected for the CDL wavelength and Power, according to the peak of Power set at device (980nm wavelength: Ppeak power of 10 W, 15 W, and 20 W, or 1470 nm wavelength: Ppeak 3 W, 5 W, 7 W, 10 W). At the end of the experiment, the laryngotracheal specimen was extracted and sent for histology and morphometry measurements (incision size, depth, area, and lateral thermal damage). Hemodynamic data and arterial blood gases were recorded during the incisions. Statistical analysis of the comparisons between the parameters and groups had a level of significance of p < 0.05. Twenty-six pigs were divided into CDL 980 nm (n = 11) and 1470 nm (n = 15). There was a greater incision area at the thyroid level in the 980 nm CDL and a wider incision at the trachea level, with a larger distance between mucosa borders. There were no significant differences in the area of lateral thermal damage between the two groups and neither difference among the power levels tested. Both wavelengths tested showed similar results in the various combinations of power levels without significant differences in the lateral thermal damage. The posterior laryngofissure incision can be performed by either of the wavelengths at low and medium power levels without great difference on lateral thermal damage.

Endoscopic posterior ventricular cordectomy with contact diode laser: how I do it

BackgroundThe treatment of bilateral vocal fold paralysis is mainly surgical and several procedures can be used to guarantee adequate breathing. Furthermore, other causes of the narrowing of the natural airways could coexist and the treatment should consider all of them.MethodsA supraglottic extension of posterior cordectomy to the false homolateral chord is described, which provides a further widening of the airway while maintaining acceptable voice quality.ConclusionEndoscopic posterior ventricular cordectomy performed by contact diode laser may be a viable and safe option, especially in those patients who present bilateral vocal fold paralysis associated with various degrees of laryngospasm.

The outcome of ciliary body ablation with diode laser contact transscleral cyclophotocoagulation in 6 months follow-up.

The aim of the study is to analyse the postoperative results of continuous wave, transscleral cyclophotocoagulations (CW-TSCPC) in 6 months follow-up for patients with refractory glaucoma.&#x0D; Material and methods: We retrospectively reviewed 58 records of patients who underwent the transscleral cyclophotocoagulation because of refractory glaucoma at the Department of Ophthalmology, Poznan University of Medical Sciences, Poland, between 2016 and 2022. All patients underwent ophthalmological examination at baseline and during follow-up visits including best-corrected visual acuity, intraocular pressure measurement (IOP), slit-lamp examination, visual field and optical coherence tomography examination of the retinal nerve fiber layer (OCT RNFL). Follow-up time was 6 months.&#x0D; Results: We analyzed a group of 58 patients (28 women and 30 men, average age of 62). Majority of patients (41 eyes, 70.69%) had secondary open angle glaucoma. There were no serious complications of the CW-TSCPC procedure. We achieved IOP normalization (IOP below 22 mmHg) in 81.03% of eyes in 1 month follow-up, in 81.08% after 2 months, and in 72.41% after 6 months. Mean IOP reduction was 53.47%, 47.71%, and 47.65% from baseline at 1, 2, and 6 months, respectively. The number of medications taken by patients was lowered of 74.14%, 70.27% and 68.97% after 1, 2 and 6 months respectively. 17 eyes (29.31%) required additional surgical interventions within 6 months.&#x0D; Conclusions: CW-TSCPC is an effective and safe procedure. It allows lowering of IOP and reduction of drugs number administrated by patients with various types of glaucoma during 6 months follow-up. The procedure is technically easy and with well-controlled postoperative complications.

TRANSSCLERAL DIODE CYCLOPHOTOCOAGULATION IN TREATMENT OF GLAUCOMA.

To assess efficiency and safety of diode cyclophotocoagulation (CPC). Retrospective study included 81 eyes with advanced glaucoma operated with CPC for elevated intraocular pressure (IOP) from January 2017 to January 2019. CPC was performed in retrobulbar anesthesia with contact diode laser FOX (A.R.C. Laser, Germany) of wavelength 810 nm, transsclerally to the ciliary body. Energy settings: intensity 2 W, exposition time 2 s, 18 applications in arc of 360°. Decrease of intraocular pressure was investigated during month 1, 6 and 12 after CPC. Safety was evaluated according to the best corrected visual acuity (BCVA) on Snellen optotypes and number of postoperative complications. Study on 31 eyes of 24 patients, 21 (68 %) women and 10 (32 %) men, with follow-up during more than 12 months. Mean follow-up time was 19.5 ± 6.1 (from 12 to 29) months. Average age was 75.9 ± 9.2 (56 - 93) years. Indication for CPC was primary open angle glaucoma in 15 eyes (49 %), primary angle closure glaucoma in 6 eyes (19 %) and secondary glaucomas in 10 eyes (32 %). All patients were on therapy of 4 antiglaucomatic drops and 10 of them (32 %) on acetazolamide pills. IOP before CPC was 25.4 ± 11.0 (13-56) mm Hg. After 1 year IOP decreased to 16.9 ± 6.1 (8-40) mm Hg. Best corrected visual acuity (BCVA) before CPC was 0.39 ± 0.34 (0-1), 1 year after CPC 0.36 ± 0.33 (0-1). 1 year after CPC, 11 eyes (35 %) lost 0.23 ± 0.14 rows. 6 from these (19 %) due to other acquired ocular pathologies. Hypotony occurred in 6 % and uveitis in 10 % eyes. CPC is asafe and effective method of lowering IOP.

Posterior laryngofissure using a surgical contact diode laser: an experimental feasibility study.

To evaluate the feasibility of a 980-nm contact diode laser (CDL) as a method for creating a posterior laryngofissure in live pigs. Twenty-eight Landrace pigs (15-20kg) were anesthetized, intubated, ventilated, and submitted to a cervical tracheostomy. An anterior and posterior midline longitudinal laryngofissure incision was created according to randomization-control (n = 4), posterior laryngofissure with a scalpel blade; electrocautery (n = 12), posterior laryngofissure by electrocautery (10, 15, 20, 25W powers); CDL (n = 12), posterior laryngofissure by the CDL (10, 15, 20, 25W peak powers in pulsed mode). Larynx and proximal trachea were excised, prepared for histopathology, and digital morphometric analysis. Measurements in and within each group were analyzed (Kruskal-Wallis and Dunn test) with a level of significance of p < 0.05. Incision width was not different between the groups, as well as in the powers used in CDL (p = 0.161) and electrocautery group (p = 0.319). The depth of the incisions was smaller in the Laser group compared to control (p = 0.007), and in the electrocautery compared to control (p = 0.026). Incision area was smaller in CDL compared with the control (p = 0.027), and not different between laser and electrocautery groups (p = 0.199). The lateral thermal damage produced by electrocautery was the largest, with a significant difference between laser and electrocautery (p = 0.018), and between electrocautery and control (p = 0.004), whereas the comparison between laser and control showed no significant differences (p = 0.588). The posterior laryngofissure incision using a 980-nm CDL is feasible resulting in smaller incisional area and less lateral thermal damage.

Contact Laser and Skeeter Microdrill Repair of Choanal Atresia in Low‐Birth Weight Neonates: 10‐Year Study

Objectives: Describe and demonstrate by video the transnasal endoscopic repair of bilateral mixed or bony choanal (BMCA/BBCA) in low-weight newborns using 1.7-mm diameter telescope and a 0.3- to 06-mm diameter fiber-delivered contact diode laser (CDL) at 810-nm wavelength and combined use of Skeeter stapes microdrill. Methods: Prospective study at a tertiary-care pediatric institution of 11 neonates with BMCA or BBCA, aged 3 to 11 days, weighing 1.8 kg to 2.5 kg. A transnasal endoscopic approach with contact diode laser and/or combined use of skeeter microdrill was applied in all children. All patients were stented bilaterally from 4 to 13 weeks. Patients were followed by serial weekly clinical examinations, rigid endoscope examination at stents removal and/or revision surgery, with subsequent revision surgery if needed. Second surgical revision was performed in 5 children, while 1 child required a third procedure. Five children required 1 procedure only. Further postoperative endoscopic examinations were scheduled for 3, 6, 12 months, and then an annual endoscopic examination was performed. Results: No complication after surgery was encountered, and all children were discharged the second day after surgery. Follow-up time frame ranged from 1 to 10 years. Neither restenosis nor craniofacial growth abnormality was seen. Conclusions: BMCA/BBCA was successfully repaired using this narrow endoscopic contact combined microdrill/laser approach, with no complications and a reduced need for revision surgery compared with prior reports. This new surgical technique is demonstrated to treat BMCA/BBCA in small birth weight neonates. Further studies are warranted.

Virtual reality simulator for training on photoselective vaporization of the prostate with 980 nm diode laser and learning curve of the technique

ObjectiveThe utility of a virtual reality simulator for training of the photoselective vaporization of the prostate with diode laser was studied. Materials and methodsTwo experiments were performed with a simulator (VirtaMed AG, Zürich, Switzerland) with software for specific training in prostate vaporization in contact mode with Twister fiber (Biolitec AG, Jena, German). Eighteen surgeons performed ablation of the prostate (55cc) twice and compared the score obtained (190 points efficacy and 80 safety) in the second one of them by experience groups (medical students, residents, specialists). They also performed a spatial orientation test with scores of 0–6. After, six of these surgeons repeated 15 ablations of the prostate (55 and 70ml). Improvement of the parameters obtained was evaluated to define the learning curve and how experience, spatial orientation skills and type of sequences performed affects them. ResultsGlobal efficacy and safety score were different according to the grade of experience (P=.005). When compared by pairs, specialist-student differences were detected (p=0.004), but not specialist-resident (P=.12) or resident-student (P=.2). Regarding efficacy of the procedure, specialist-student (p=0.0026) and resident-student (P=.08) differences were detected. The different partial indicators in terms of efficacy were rate of ablation (P=.01), procedure time (P=.03) and amount of unexposed capsule (p=0.03). Differences were not observed between groups in safety (P=.5). Regarding the learning curve, percentage median on the total score exceeded 90% after performing four procedures for prostates of 55ml and 10 procedures for prostate glands of 70ml. This course was not modified by previous experience (resident-specialist; P=.6). However, it was modified according to the repetition sequence (progressive-random; P=.007). Surgeons whose spatial orientation was less than the median of the group (value 2.5) did not surpass 90% of the score in spite of repetition of the procedure. ConclusionSimulation for ablation of the prostate with contact diode laser is a good learning model with discriminative validity, as it correlates the metric results with levels of experience and skills. The sequential repetition of the procedure on growing levels of difficulty favors learning.

Simulador de realidad virtual para el entrenamiento en vaporización fotoselectiva de la próstata con láser de diodo 980 nm y curva de aprendizaje de la técnica

ObjectiveThe utility of a virtual reality simulator for training of the photoselective vaporization of the prostate with diode laser was studied. Material and methodTwo experiments were performed with a simulator (VirtaMed AG, Zürich, Switzerland) with software for specific training in prostate vaporization in contact mode with Twister fiber (Biolitec AG, Jena, German). Eighteen surgeons performed ablation of the prostate (55cc) twice and compared the score obtained (190 points efficacy and 80 safety) in the second one of them by experience groups (medical students, residents, specialists). They also performed a spatial orientation test with scores of 0 to 6. After, six of these surgeons repeated 15 ablations of the prostate (55 and 70ml). Improvement of the parameters obtained was evaluated to define the learning curve and how experience, spatial orientation skills and type of sequences performed affects them. ResultsGlobal efficacy and safety score was different according to the grade of experience (P=.005). When compared by pairs, specialist-student differences were detected (p=0.004), but not specialist-resident (P=.12) or resident-student (P=.2). Regarding efficacy of the procedure, specialist-student (p=0.0026) and resident-student (P=.08) differences were detected. The different partial indicators in terms of efficacy were rate of ablation (P=.01), procedure time (P=.03) and amount of unexposed capsule (p=0.03). Differences were not observed between groups in safety (P=.5). Regarding the learning curve, percentage median on the total score exceeded 90% after performing 4 procedures for prostates of 55ml and 10 procedures for prostate glands of 70ml. This course was not modified by previous experience (resident-specialist; P=.6). However, it was modified according to the repetition sequence (progressive-random; P=.007). Surgeons whose spatial orientation was less than the median of the group (value 2.5) did not surpass 90% of the score in spite of repetition of the procedure. ConclusionSimulation for ablation of the prostate with contact diode laser is a good learning model with discriminative validity, as it correlates the metric results with levels of experience and sills. The sequential repetition of the procedure on growing levels of difficulty favors learning.

Telerobotic contact transscleral cyclophotocoagulation of the ciliary body with the diode laser

To assess the feasibility of using the Robotic Slave Micromanipulator Unit (RSMU) to remotely photocoagulate the ciliary body for the treatment of glaucoma with the diode laser. In fresh unoperated enucleated human eyes, the ciliary body was destroyed either with a standard contact transscleral cyclophotocoagulation 'by hand' diode laser technique, or remotely using the RSMU. The treated sections were fixed in formalin, paraffin-embedded, and stained with hematoxylin and eosin. Histological evaluation was performed by a masked observer using a standardized grading system based on the amount of damage to the ciliary body to evaluate effectiveness of treatment. Both methods of contact transscleral cyclophotocoagulation showed therapeutic tissue disruption of the ciliary processes and both the non-pigmented and pigmented ciliary epithelium. Histology examination of remote robotic contact transscleral cyclophotocoagulation and "by hand" technique produced similar degrees of ciliary body tissue disruption. Remote diode laser contact transscleral cyclophotocoagulation of the ciliary body in fresh enucleated human eyes is possible with the RSMU. Therapeutic tissue disruption of the ciliary body was achieved. Additional study is necessary to determine the safety and efficacy of robotically-delivered cyclophotocoagulation in live eyes.

The modality‐specific contribution of peptidergic and non‐peptidergic nociceptors is manifest at the level of dorsal horn nociresponsive neurons

We previously demonstrated that genetic and/or pharmacological ablation of the TRPV1+/peptidergic or the MrgprD+/non-peptidergic subset of nociceptors produced selective, modality-specific deficits in the behavioural responses to heat and mechanical stimuli, respectively. To assess whether this modality-specific contribution is also manifest at the level of spinal cord neuron responsiveness, here we made extracellular recordings from lumbar dorsal horn neurons of the mouse in response to graded thermal and mechanical stimulation. We found that, following intrathecal injection of capsaicin to eliminate the central terminals of TRPV1+ nociceptors, neurons in the region of laminae I and V of the spinal cord lost responsiveness to noxious heat (whether generated by a contact heat probe or diode laser), with no change in their response to noxious mechanical stimulation. In contrast, ablation of MrgprD+ afferents did not alter the response to noxious heat, but reduced the firing of superficial dorsal horn nociceptive-specific neurons in response to graded mechanical stimulation and decreased the relative number of wide dynamic range neurons that were exclusively mechanosensitive. Neither ablation procedure reduced the number of dorsal horn neurons that responded to noxious cold. These findings support the conclusion that TRPV1+ nociceptors are necessary and probably sufficient for noxious heat activation of dorsal horn neurons and that, despite their polymodal properties, TRPV1+ and MrgprD+ nociceptors provide modality-specific contributions to the response properties of spinal cord neurons.

Use of diode lasers in treatment of oral submucous fibrosis: A new concept in surgical management

Oral submucous fibrosis is chronic, insidious disease affecting the oral cavity and sometimes the pharynx and rarely the tongue. Oral Submucous fibrosis is a well known clinical entity since the time of “Sushruta” as ‘Vidari’. A 20-year-old patient with oral submucous fibrosis was treated with contact diode laser under local anesthesia and was followed up for six months. Oral submucous fibrosis is an established precancerous condition with increased prevalence in the Indian subcontinent. The treatment of oral submucous fibrosis is a challenging task for a clinician. Different authors have suggested variety of treatment modalities and have claimed success rates; still there is no universally acceptable protocol for the management of oral submucous fibrosis. In this case transection of bands was done by contact diode lasers under local anaesthesia and it offered good results. Diode lasers offered excellent results and had many advantages over conventional surgical treatment.

Toward Robot-Assisted Neurosurgical Lasers

Despite the potential increase in precision and accuracy, laser technology is not widely used in neurological surgery. This in part relates to challenges associated with the early introduction of lasers into neurosurgery. Considerable advances in laser technology have occurred, which together with robotic technology could create an ideal platform for neurosurgical application. In this study, a 980-nm contact diode laser was integrated with neuroArm. Preclinical evaluation involved partial hepatectomy, bilateral nephrectomy, splenectomy, and bilateral submandibular gland excision in a Sprague-Dawley rat model (n = 50). Total surgical time, blood loss as weight of surgical gauze before and after the procedure, and the incidence of thermal, vascular, or lethal injury were recorded and converted to an overall performance score. Thermal damage was evaluated in the liver using tissue samples stained with hematoxylin and eosin. Clinical studies involved step-wise integration of the 980-nm laser system into four neurosurgical cases. Results demonstrate the successful integration of contact laser technology into microsurgery, with and without robotic assistance. In preclinical studies, the laser improved microsurgical performance and reduced thermal damage, while neuroArm decreased intra- and intersurgeon variability. Clinical studies demonstrate dutility in meningioma resection (n = 4). Together, laser and robotic technology offered a more consistent, expedient, and precise tool for microsurgery.

Outcome of Diode Laser Cyclophotocoagulation in Neovascular Glaucoma in Nigerians: A short-term follow-up

Aim: To find out the short-term outcome of ciliary ablation with diode laser contact cyclophotocoagulation in Nigerians with neovascular glaucoma.Methods: The study is a retrospective, non-comparative, interventional case series. Demographic data, ocular and systemic history were obtained. Clinical examination included visual acuity, intraocular pressure, number ofintraocular pressure-lowering medications and type of treatment administered at the time of NVG diagnosis. Treatment with diode laser cyclophotocoagulation was instituted. Short-term outcomes were observed and patients were followed-up for three months.Results: The study included 3 eyes of 3 patients; all above 40 years, 1 female and 2 male. At the time of NVG diagnosis, all three patients presented with severe ocular pain, and had VA between PL and NPL. Intraocular pressure on the average was 33mmHg at presentation,and associated with corneal oedema. At 3 months after initial diode laser photocoagulation (DLPC), the VA remained the same in all patients. No patient required repeat treatment. Pain reduction and lowering of theintraocular pressure were achieved at 3 months followup post-DLPC without anti-glaucoma medication. Conjunctival burns and chemosis were seen. All three eyes had corneal oedema and spontaneous hyphema by the 7 day; with subsequent s th evere corneal blood stain.Conclusions: Diode laser photocoagulation can be used as an acceptable non-invasive surgical intervention for the reduction of pain and lowering of intraocular pressure in Nigerians with neovascular glaucoma. Most shortterm complications are uneventful. The presence of hyphema with corneal oedema may enhance the occurrence of corneal blood stain in black people. The presence of corneal oedema may thus be a risk factor for corneal blood staining.Key words: short-term outcome, diode laser, corneal staining

Diode laser contact vaporization of the prostate on a day-surgery basis: early complications and short-term follow-up of 63 cases

Diode laser contact vaporization of the prostate on a day-surgery basis: early complications and short-term follow-up of 63 cases

A Comparative Study Between Diode Laser Cyclophotocoagulation and the Ahmed Glaucoma Valve Implant in Neovascular Glaucoma

To compare the efficacy, safety, and long-term results of intraocular pressure (IOP) reduction by diode laser contact cyclophotocoagulation (DCPC) and Ahmed glaucoma valve (AGV) implant in cases of neovascular glaucoma. A total of 66 eyes of 66 patients with neovascular glaucoma were prospectively assigned to either DCPC or AGV implantation. All patients underwent a baseline complete ophthalmologic examination and IOP measurement by Goldmann applanation tonometry before and after 1,3, 6, 12, and 24 months follow-up. Complications and the number of medications were recorded. Mean age of the patients was 60.0+/-11.7 years (range: 20 to 85) in the DCPC group and 57.2+/-10.3 years (range: 20 to 85) in the AGV group. The preoperative IOP was 43.4+/-11.9 mm Hg and 43.3+/-7.4 mm Hg for the DCPC and AGV group, respectively (P>0.05). The postoperative IOP was 16.5+/-11.3 mm Hg and 22.09+/-7.6 mm Hg for the DCPC and AGV groups, respectively (P>0.05) at the last visit. Kaplan-Meier survival analysis showed a probability of success at 24 months of 61.18% and 59.26% for the DCPC and AGV groups (P>0.05). All the patients had a visual acuity of hand movement or worse preoperatively. Visual acuity decreased in 6 eyes (24%) in the DCPC group and 9 eyes (27%) in AGV group. Complications included anterior segment inflammation in 5 eyes (20%), neurotrophic keratitis in 2 eyes (8%), and hypotony in 3 eyes (15%) in the DCPC group and hyphema in 5 eyes (15%) and tube occlusion in 3 eyes (9%) in AGV group. There was no significant difference in the success rate between the DCPC and AGV implantation in neovascular glaucoma treatment. However, DCPC is less time consuming and easier method for lowering IOP in patients with neovascular glaucoma.

Ciclodiálisis postraumática tratada con láser diodo transescleral

A 28-year-old man who received a blunt trauma in his left eye, presented with persistent ocular hypotony (intraocular pressure: 4 mmHg) as well as loss of visual acuity (0.4), optic disc edema and chorioretinal folds in the macula. The foveal thickness, measured by optic coherence tomography, was 326 microns. Using ultrasound biomicroscopy, a desinsertion of the nasal iris and a 360 degrees choroidal detachment was observed. The hypotony did not respond to conservative treatment and 10 months after the trauma he underwent a transscleral cyclopexy with contact diode laser. One year after the laser treatment the visual acuity was 1.0, the intraocular pressure 14 mmHg and the foveal thickness 240 microns. Transscleral cyclopexy with diode laser may be an effective alternative treatment to resolve post-traumatic cyclodialysis that does not respond to medical treatment.

Contact-diode laser repair of bony choanal atresia: A preliminary report

To demonstrate the use of the contact-diode laser (CDL) at 810 nm wavelength for the transnasal endoscopic repair of bilateral bony choanal (BBCA) in low-weight newborns. Prospective study at a tertiary-care pediatric institution of four neonates with BBCA aged 3-5 days, weighing on average 2.34 kg. BBCA was opened by transnasal delivery of CDL through a 600 microm diameter glass fiber. Children were stented post-operatively, and revision surgery performed when needed. All children were successfully treated for BBCA with CDL. Two children needed only one surgery, one child needed two surgeries, and one patient required three procedures, in order to establish patient choanae at last follow-up ranging from 16 to 30 months. We found the fiber-delivered contact-diode laser to permit correction of BBCA in four low-birth weight neonates. To the best of our knowledge, this report is the first to demonstrate the successful use of CDL for the management of BBCA.

Effect of Diode Laser Cyclophotocoagulation on the Anterior Segment

To evaluate the effect of transscleral contact diode laser cyclophotocoagulation (TCDLC) on corneal topography, central corneal thickness (CCT), and anterior-chamber depth (ACD). The Orbscan II system was used to determine the changes in corneal topography, CCT, and ACD before and after TCDLC in 25 eyes of 24 patients. Mean prelaser astigmatism was 4.51 +/- 1.81, 4.64 +/- 3.47, and 5.40 +/- 3.04 D at central and 3- and 5-mm zones, respectively. Mean postlaser astigmatism was 4.54 +/- 2.59, 4.75 +/- 3.33, and 5.57 +/- 3.12 D at central and 3- and 5-mm zones at 10 days and 3.99 +/- 2.01, 4.05 +/- 2.20, 5.52 +/- 4.60 D at 1 month, respectively, showing no statistically significant difference. Prelaser CCT was 540.72 +/- 103.48 microm. Postlaser CCT was 617.08 +/- 86.35 microm at 10 days and 569.88 +/- 70.36 microm at 1 month. CCT was significantly thicker at 10 days compared with prelaser CCT, whereas CCT at 1 month was not statistically different. ACD showed a nonsignificant decrease after TCDLC from 3.77 +/- 0.81 to 3.38 +/- 0.85 mm at 10 days and 3.58 +/- 0.78 mm at 1 month. TCDLC does not alter corneal topography or ACD significantly. However, CCT increases during the 10 days after TCDLC and returns to normal at 1 month, which might be related to the inflammation induced by cyclophotocoagulation. Increased CCT may lead to artificially high intraocular pressure measurements within the first 4 weeks after surgery.

Excision Biopsy of Tongue Lesions by Diode Laser

The aim of this study was to evaluate the diode laser in excision biopsy of superficial proliferative tongue lesions under local anesthesia. Most mobile tongue lesions present as surface projections and have similar clinical features. They are usually excised for diagnostic purposes using conventional surgery or electrosurgery. The diode laser has proven itself useful in different oral surgeries. We report the results of a prospective pilot study where contact diode laser was used in excision biopsy of six mobile tongue lesions. All excised tissues were pathologically examined. To assess post-operative pain, patients were asked to correlate it to an 11-point Visual Analogue Scale (VAS); patients were also asked to assess their impression of alteration in tongue size on a 4-point scale. Healing, functional results, and recurrence rate were assessed. All interventions were uneventful and done at the same out-patient setting. All lesions were benign. Healing occurred by secondary intention in the six cases with no residual ulceration. Postoperative pain was mild in four cases, while two cases suffered from moderate pain. Post-operative impression of tongue swelling occurred in all cases. The mild impression disappeared by the end of the first week and the moderate one by the end of the second week. No recurrence was observed over a mean follow-up period of 15 months. The diode 980-nm laser is optimal for excision biopsy of superficial and benign proliferative lesions of the mobile tongue.

Subglottic cysts in children: A 10-year review

Subglottic cysts are associated with prematurity and periods of early neonatal intubation and are a rare cause of infant stridor. In this study we analyse our experience of this rare but important problem. We discuss the aetiology, diagnosis and management of subglottic cysts. We carried out a retrospective review of all cases of subglottic cysts presenting to the otorhinolaryngology department at the Leeds teaching hospitals trust during the period between 1995 and 2005. In total seven patients were identified. A retrospective review of the case notes of all patients proven to have subglottic cysts at direct laryngoscopy and bronchoscopy was undertaken. Seven patients were identified, four males and three females. Five were born premature (24-31 weeks). All were intubated with average intubation period of 20.6 days. Six of our patients' underwent endoscopic marsupialisation using cup forceps and one with a contact diode laser. Two patients had recurrence of the cyst and had a repeat of endoscopic marsupialisation. This study highlights the associated risk of neonatal intubation with the risk of formation of subglottic cysts, and the need for early diagnosis and appropriate treatment to avoid unnecessary morbidity.