Sharplan Lasers Research Articles

THE LAST AND FOND FAREWELL

THE LAST AND FOND FAREWELL

Carbon dioxide laser treatment of rhinophyma: a review of 124 patients

Rhinophyma is a progressive, localized or generalized nasal deformity resulting from hypertrophy of sebaceous and connective tissue. The CO(2) laser has been used for treatment of rhinophyma, but the long-term efficacy of the treatment is unknown. To review the outcome of 124 patients with rhinophyma treated with the CO(2) laser between 1996 and 2008 in our centre. Exuberant sebaceous tissue was ablated using the Sharplan 40C CO(2) laser (Sharplan Lasers UK Ltd, London, U.K.) under local anaesthesia. The technique varied with the severity of rhinophyma; the laser was used in a continuous mode to debulk the larger rhinophymas, and in a resurfacing mode (Silk Touch scanner; Sharplan, 4-7-mm spot at 20-40 W) or continuous mode (10-20 W using a defocused 2-3-mm beam) to reshape the nasal contours. Outcomes were determined by case notes, clinical review and questionnaire. Laser treatment was completed in a single session in 115 of 124 patients. All patients were reviewed 3 months post-treatment. Results were classified as good to excellent in 118 and poor in six patients. All patients were sent a satisfaction questionnaire in 2008 and 52 patients replied. Patients reported high levels of satisfaction following treatment. The post-treatment response at 3-month review was maintained long term. The main complications were pain associated with injection of local anaesthetic, scarring and hypopigmentation (four patients) and open pores (two patients). The CO(2) laser is an effective and durable treatment for rhinophyma. Treatment carries a low risk of side-effects and is associated with high patient acceptability and satisfaction.

Long-Term Results of Upper Lips Treated for Rhytides with Carbon Dioxide Laser

Carbon dioxide laser resurfacing has been widely reported as an effective method for smoothing facial rhytides. However, limited series have been published describing the long-term results. This retrospective study was undertaken to assess the long-term aesthetic results of upper lips treated for rhytides with the SilkTouch carbon dioxide laser (Sharplan Lasers, Inc., Warwick, R.I.). The results of 35 patients were reviewed and evaluated, including patient demographics, skin type, laser pass data, laser parameters, and long-term aesthetic results and complications. Aesthetic results were graded by independent reviewers using a standardized photographic rhytide scale, and all patient satisfaction rates were evaluated by means of a five-point visual analogue scale. Rhytides were almost completely ablated at 3-month follow-up. A persistence of approximately 81 percent of the rhytide reduction was shown at a follow-up period of 2.1 to 6.3 years (average, 4.5 years). Most of the patients would undergo the procedure again and would recommend it to their friends. The only drawback and main long-term complication was the high rate of hypopigmentation (57.1 percent). This study clearly demonstrates that laser resurfacing with the SilkTouch carbon dioxide laser is a highly effective treatment of rhytides of the upper lip that will last for a long time, but there is a high rate of hypopigmentation.

The search for a youthful upper lip via laser resurfacing.

Generally, the upper lip resembles a bow of harmonious shape, characteristic of youthfulness. At the lip, noticeable wrinkles develop with aging, and these wrinkles can be successfully treated with laser resurfacing. Ideally, the aim of the treatment should include not only the wrinkles but the recovery of the whole aesthetic configuration of the upper lip. The study includes 236 patients treated for wrinkles of the upper lip either with the Coherent 5000C pulsed CO2 technology (300 mJ, density 6) or with the Flashscanning continuous wave emission, also CO2 technology (Sharplan FeatherTouch 36 W). Once resurfacing was done, passing the laser three times over the whole surface to recover the upper lip from the aging appearance of wrinkles, three more passes (same laser parameters) were performed at the area of the philtrum to reshape the Cupid’s bow. Biopsies were taken to examine possible particular implications of tissue behavior and the role in the recovery of the anatomy and aesthetics of young lip characteristics after resurfacing, using the proposed technique. Laser resurfacing, done with a few more passes at the philtrum area, reshapes the anatomic-aesthetic youthful appearance of the upper lip and fully recovers the appearance of the Cupid’s bow. Results proved to be about the same when using the Coherent or the Sharplan laser. The sum of “very good” (e.g., equal to >80 percent clinical improvement and >60 percent improvement for “good” results, for both systems) was as follows: (1) Sharplan, rate of success 52 percent “very good” and 35 percent “good,” and (2) Coherent, rate of success 40 percent “very good” and 50 percent “good” against a group of 118 patients treated with each laser. No bad results were scored. Histologic samples after laser resurfacing showed effects down to the reticular dermis, which, anatomically, is closely related to muscle layer because of the nonexistence of a subcutaneous fat layer. Two months later, tissue showed signs that typically appear after laser resurfacing, that is to say, there was a rich broad band of compacted collagen present immediately below the epidermis-dermis junction. This band could be very well distinguished from collagen before laser treatment, which was lax and presented clear signs of elastosis. The orbicular, the main muscle surrounding the mouth, is attached to the dermis with practically no layer of fat in between. Thus, when the technique is used as described, extra laser passes will promote a more compacted rich band of collagen that efficiently stretches the fibers of the mirtiform muscle which lies in direct connection with the philtrum and its physiognomy. Extra pulling on this particular location, related to the philtrum, will result in reshaping the anatomic and aesthetic lip configuration. Laser resurfacing offers possibilities of enhancing the results of lip rejuvenation by improving the vermilion appearance and the aesthetic pattern with little risk of complications.

Three years of clinical evaluation of endodontically treated teeth by 15 F CO2 laser microprobe: in vivo study.

Evaluation of the efficiency of 15 F CO2 laser microprobe, in cases of periapical lesions. The elimination of the pathological reaction caused by certain species of bacteria by reduction of reinfection and stimulation of osteogenesis. Until now, no suitable delivery fiber existed for CO2 laser endodontic radiation in the apical region where it is most difficult to eliminate the pulp tissue using conventional methods. To overcome this problem, Sharplan Lasers designed a microprobe that reaches closer to the apex, distributing the energy density to a smaller area of the root canal, thus favorably increasing the thermal effects. The study was conducted on 900 teeth, corresponding to 1512 root canals, divided in two groups. Four hundred sixty-eight were new cases, carefully selected according to strict parameters such as wide periapical translucency over 1 mm, supported by digital x-ray, with a lesion of 3 mm and more. All root canals were mechanically prepared in the conventional method up to size 35, Physiological saline solution served as rinsing solution and the root canals were treated by 15 F CO2 laser microprobe for 60 pulses repeatedly. The temperature at the surrounding tissue of the root did not exceed 38 degrees C. Filling of the canal was possible at the same appointment, without antibiotic treatment. Four hundred thirty-two of the cases, which were referred to us by other dentists after an unsuccessful treatment according to the classic therapy, were treated by the same laser therapy. Follow-up was performed by clinical examination, and a digital x-ray was taken, during and after treatment as well as after 3, 6, 9, and 12 months. There is a 98% success rate in both study groups, according to objective criteria for successful treatment including reduction of apical translucency after 2-6 months, freedom from clinical complaints, and no need for periapical surgery.

Carbon dioxide laser resurfacing of the aged face.

Aging of the skin of the face consists of an intrinsic aging process that is genotypically inherent and inevitable, which accounts for the thinness of tissue that is lax and redundant. It can include benign and premalignant neoplasms [1, 2]. While photoaging or extrinsic aging is environmentally mediated and is characterized by fine and deep facial skin wrinkling; it can be characterized by thickened, coarse, yellow, sallow skin, that is studded with telangiectasia, macules of hyper-and hypopigmentation, benign, premalignant and malignant neoplastic lesions [1, 3—6]. There are many ways to rejuvenate aged skin, which include topical treatments with vitamin A acid [7,8], alpha and beta hydroxy acids [9, 11] and various types of skin resurfacing either by chemical peelings of glycolic, trichloracetric or phenolic acids for superficial, medium to deep depth resurfacing respectively [12, 13], or by performing a mechanical dermabrasion [14, 17]. This presentation will highlight rejuvenating the photodamaged and aged skin of the face by the currently most popular modality of resurfacing, which is using a high energy carbon dioxide laser that is either pulsed or flashscanned [18—23].

Electron microscopy comparison of CO2 laser flash scanning and pulse technology one year after skin resurfacing.

The recent adaptation of laser technology in plastic and dermatologic surgery has provided a means to reduce efficiently the irregularities of the surface of the skin. Previous studies have analyzed the short- and medium-term clinical and histologic results of two laser systems: the Sharplan 40C SilkTouch and the 5000C Coherent Ultrapulse with Computer Pattern Generator (CPG). This paper contains the long-term ultrastructural findings observed with the aid of transmission electron microscopy (TEM). Twenty skin biopsy specimens were taken from ten Caucasion patients, between 54 and 72 years of age, who had undergone facial skin resurfacing with a CO2 laser 1 year previously. The treated areas of the face were divided into two equal parts. One half of the face was treated with the Sharplan SilkTouch laser and the other half with the Coherent Ultrapulse laser. Using TEM, the cell composition of the epidermis was studied ultrastructurally, as were the dermal-epidermal junction (DEJ) and the different fibers and cells in the superficial and middle dermis. On the side treated by the Sharplan laser, little melanin was observed, the DEJ was thicker, and there were abundant collagen fibers well compacted in the dermis. Also present was abundant elastin fiber with scarce interstitial spaces. On the side treated by the Coherent, the melanin was abundant and the DEJ was well structured. There were fibroblasts with lax chromatin in the dermis and collagen fibers in the papillary dermis oriented in a vertical and horizontal manner in relation to the epidermis. There was little elastin. The interstitial spaces were abundant. The Sharplan laser system seems to provoke a significantly more intense tissue response, with abundant dermal collagen and elastic fibers. This indicates that the Sharplan 40C SilkTouch might produce longer lasting clinical effects.

Laser Hair Transplanting 1997

The purpose of this article is to review the author's experience with the Ultrapulse CO2 laser and the Sharplan CO2 laser. Histologically, the best settings for five- to six-hair slit graft sites produced with the Ultrapulse scanner are pattern 4, 300–325 mJ, and 40–60 W; the best settings for Sharplan-produced 0.8-mm round holes for two- to three-hair grafts are 0.1–0.15 seconds and 50–80 W. Cosmetic results have been superior in Ultrapulse-laser-slittreated areas in 285 of 357 cases; they were equal in 69 of the cases and inferior in 3. Clinical results with Sharplan laser round grafted areas have not yet been assessed by the author but have shown good hair yield in the hands of other investigators. A new photographic computer-assisted five-center study has begun that will compare hair yield in laser-prepared and conventionally prepared graft sites. In the author's opinion, new lasers will undoubtedly be developed to produce even less adjacent thermal damage and better results. “Laser hair transplanting” is not merely a marketing tool.

Traitement par broncholaser CO 2 des sténoses trachéobronchiques acquises chez des enfants porteurs d'une dysplasie bronchopulmonaire

Objective. — Evaluation of carbon dioxide (CO 2) broncholaser for treating acquired proximal tracheobronchial stenosis in children with bronchopulmonary dysplasia. Design. — Retrospective study from June 1987 through August 1995, with 39 months follow-up. Patients and methods. — During the study, 65 children were treated for bronchopulmonary dysplasia. Eight of those (average age: 42.6 months) had symptomatic tracheo-bronchial stenosis; they were treated with CO 2 broncholaser and represented 23.5% of all broncholaser applications. All patients presented multiple lesions. Ten symptomatic well-organized lesions (obstructive bridles or diaphragms), all accessible to broncholaser, were treated. Broncholaser was the primary treatment used, except in one case where it was used following balloon dilatation failure. An adaptable rigid fibroscope combined with a CO 2 Sharplan laser was used. All interventions were performed under general anesthesia. Results. — Lesions not reaching the trachea's bifurcation (eight cases) disappeared following one laser session with significant clinical improvement. Lesions extending to the trachea's bifurcation (two cases) only showed partial improvement despite three laser sessions. The results remained stable throughout the follow-up period. There were no major complications. Conclusions. — Broncholaser is a safe and efficient method of treating stenoses occurring in patients with bronchopulmonary dysplasias. Obstructive lesions (such as bridles or diaphragms) and those which do not reach the trachea's bifurcation, give the best results.

The place of laser resurfacing within the range of medical and surgical skin resurfacing techniques.

The history of resurfacing procedures used to treat the aging face is reviewed, and the place of laser resurfacing within this context is described. The changing medical reimbursement system and desire by "baby boomers" to maintain a youthful image have driven the technical development of laser resurfacing. Medical management of the skin begins with prevention of photodamage by sunscreens and education about sun protection. The next step in management of the aging face is therapy with alpha-hydroxy acid creams and topical tretinoin. Finally, the resurfacing procedures of chemical peels, dermabrasion, and lasers are the next step. The treatment of the aging face with medical and surgical methods has been enhanced over several decades by new and existing topical agents and surgical treatments. The advent of laser resurfacing in the 1990s occurring with the introduction of the Coherent Ultra-Pulse CO2 (Coherent Laser, Palo Alto, CA) and Sharplan Silk Touch (Sharplan Lasers, Inc, Allendale, NJ) lasers has added new therapeutic options for our patients. The combination of new resurfacing lasers with traditional surgical procedures will probably be the ideal approach to the treatment of the aging face.

Cutting characteristics of the Nd: YAG contact technique using a laser with tissue effect control, conical fibres and a normal bare fibre: First results of a physical, morphometrical and clinical study

SummaryIn the present study, a Nd : YAG laser with tissue effect control (MediLas 4060-N-Fibertom, Dornier-Medizintechnik, Munich) and two newly developed conical bare fibres (Sharplase Conical Fibers, Sharplan Lasers, Freising) were used and the cutting effect compared to that of a conventional bare fibre. Methodology: The two conical fibres had a body diameter of 600 and 800 μm, a 400 μm bare fibre served as a reference. In the first step, radiation geometry was physically measured. Subsequently, in an in vivo experiment, linear uterotomies were performed on Wistar rats with the three types of fibres and the tissue effect control system at an initial power output of 10, 15 and 20 W. Serial cuts were HE-stained and the zones of tissue damage evaluated with the Cue-2 Image Analysis System. In the third step, operative hysteroscopies and laparoscopies were performed. Results: Physical measurements showed a characteristic radiation profile for each fibre. The tissue effect control system prevents melting of...

Hair transplantation facilitated by flashscanner-enhanced carbon dioxide laser

One of the complications of hair transplantation is bleeding when the recipient sites are created in the vertex and frontal portions of the scalp. The bleeding, although rarely a problem from a hemodynamic standpoint, leads to prolonged surgical time, trauma to grafts from multiple handlings, and loss of grafts. The grafts will often pop up, and with any degree of hemorrhage, ooze out because they are not sutured in place, especially when using micrograft and minigraft techniques. Another phenomenon that can occur is graft compression. When a recipient hole or slit is created, the tissue compresses the graft, leading to presumed hypoxia and decreased hair growth. However, when tissue is vaporized with a laser, appropriate room is created for the graft to rest in its place, thus avoiding graft compression. The use of lasers in hair transplantation is only recent and the challenge in its use for this purpose is to create a cylindrical bloodless recipient site (for both micrografts and minigrafts) and at the same time to allow full graft take by minimizing the zone of thermal necrosis. This report describes full graft take following creation of the recipient sites using a Silktouch (Model 765; Sharplan Lasers Inc, Allendale, NJ) flashscanner-enhanced carbon dioxide (CO2) laser. optical density of above 300 W/mm 2 on tissue. This is considerably higher than the threshold for vaporization of tissue without residual carbon char (the threshold for char-free tissue ablation is about 50 W/mm2). 3 The time required for the Silktouch to homogeneously cover a 2-mm round area is 200 milliseconds. During this time, a 10-W operating laser will deliver 2,000 mJ to the tissue. Because the typical energy required to ablate tissue completely is about 3,000 mJ/mm 2, keeping the handpiece precisely on a single site for 1.0 seconds will generate a clean, almost char-free crater of approximately 2.5 mm in depth. A healthy 50-year-old white male with moderately advanced male-pattern baldness (Hamilton grade II, Abbott Laboratories, North Chicago, IL) volunteered for test sites. After local infiltration anesthesia with Xylocaine without epinephrine, five minigraft recipient sites were created on the vertex of the scalp, each 2 mm in diameter and 6 mm in depth, using the Silktouch-enhanced CO 2 laser. The depth of the cylindrical hole was verified using a measuring probe. The CO 2 laser was used twice in the same spot for 1.0 seconds at a power setting of 15 W. Grafts obtained from a 1.5 cm-long strip graft from the occipital scalp were cut to size and placed in the recipient holes using standard techniques. No bleeding was ob

Instrumentation for officelaser surgery

Small, transportable 20 to 30 W TEM oo carbon dioxide lasers offer capability for performance of the largest number of ear, nose, and throat office procedures with a single laser. By combining sharp 200-μm size incision capability with dedicated focused handpieces and layer-by-layer char-free ablation of extended surfaces at low-power levels with the SwiftLase flashscanner technology, such important procedures as laser-assisted uvulapalatoplasty (LAUP), tonsil cryptolysis, lingual tonsillectomy, and other oral cavity procedures can be performed in the office. Treatments normally last a few minutes, using only local anesthesia. With the laser in the superpulse mode and the beam coupled to thin, 1-mm diameter waveguides (FlexiLase, Sharplan Lasers), char-free ablation of deep nasal lesions, such as hypertrophic turbinates, can also be achieved with minimal necrosis. A modified flashscanner technology can also be used in the office for skin resurfacing and hair transplant. Although less versatile and more expensive to buy and to operate, the Nd:YAG laser offers excellent ambulatory treatment of hypertrophic nasal turbinates. Noncontact Nd:YAG fibers can be used endoscopically for the treatment of nasal epistaxis and Nd:YAG contact technology can be used for the ablation of few highly vascular lesions.

Corporate Profile: Sharplan Lasers, Inc.: Pioneer Is Back on Track with New Technology

Corporate Profile: Sharplan Lasers, Inc.: Pioneer Is Back on Track with New Technology

The SHARPLAN family of CO2 lasers for surgery.

The SHARPLAN laser systems are available with a full range of different powers: a 25 watt office system, a 40 watt and a 60 watt system for general surgery and an 80 watt for high power needs like neurosurgery, all powers measured at tissue. A full range of accessories is available for microsurgery enabling adaptation to the most popular surgical microscopes for cavitational surgery. Super-pulse models are available, minimizing the thermal damage to the tissue exposed to the laser. The interaction of the laser with living tissue and its specific use in neurosurgery are discussed.