Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry
Identifieur interne : 000405 ( Ncbi/Curation ); précédent : 000404; suivant : 000406Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry
Auteurs : Marc Rubinstein [États-Unis] ; William B. Armstrong [États-Unis]Source :
- Lasers in Medical Science [ 0268-8921 ] ; 2010.
Abstract
Transoral laser microsurgery (TLM) is an emerging technique for the management of laryngeal and other head and neck malignancies. It is increasingly being used in place of traditional open surgery because of lower morbidity and improved organ preservation. Since the surgery is performed from the inside working outward as opposed to working from the outside in, there is less damage to the supporting structures that lie external to the tumor. Coupling the laser to a micromanipulator and a microscope allows precise tissue cutting and hemostasis; thereby improving visualization and precise ablation. The basic approach and principles of performing TLM, the devices currently in use, and the associated dosimetry parameters will be discussed. The benefits of using TLM over conventional surgery, common complications and the different settings used depending on the location of the tumor will also be discussed. Although the CO2 laser is the most versatile and the best-suited laser for TLM applications, a variety of lasers and different parameters are used in the treatment of laryngeal cancer. Improved instrumentation has lead to an increased utilization of TLM by head and neck cancer surgeons and has resulted in improved outcomes. Laser energy levels and spot size are adjusted to vary the precision of cutting and amount of hemostasis obtained.
Url:
DOI: 10.1007/s10103-010-0834-5
PubMed: 20835840
PubMed Central: 2981737
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry</title><author><name sortKey="Rubinstein, Marc" sort="Rubinstein, Marc" uniqKey="Rubinstein M" first="Marc" last="Rubinstein">Marc Rubinstein</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Otolaryngology – Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Bldg 56 Room 500, Orange, CA 92868 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Otolaryngology – Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Bldg 56 Room 500, Orange</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff2">Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine</wicri:cityArea></affiliation></author><author><name sortKey="Armstrong, William B" sort="Armstrong, William B" uniqKey="Armstrong W" first="William B." last="Armstrong">William B. Armstrong</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Otolaryngology – Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Bldg 56 Room 500, Orange, CA 92868 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Otolaryngology – Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Bldg 56 Room 500, Orange</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">20835840</idno><idno type="pmc">2981737</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2981737</idno><idno type="RBID">PMC:2981737</idno><idno type="doi">10.1007/s10103-010-0834-5</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">000127</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000127</idno><idno type="wicri:Area/Pmc/Curation">000127</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000127</idno><idno type="wicri:Area/Pmc/Checkpoint">000273</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000273</idno><idno type="wicri:Area/Ncbi/Merge">000405</idno><idno type="wicri:Area/Ncbi/Curation">000405</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry</title><author><name sortKey="Rubinstein, Marc" sort="Rubinstein, Marc" uniqKey="Rubinstein M" first="Marc" last="Rubinstein">Marc Rubinstein</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Otolaryngology – Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Bldg 56 Room 500, Orange, CA 92868 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Otolaryngology – Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Bldg 56 Room 500, Orange</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff2">Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, CA USA</nlm:aff><country>États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine</wicri:cityArea></affiliation></author><author><name sortKey="Armstrong, William B" sort="Armstrong, William B" uniqKey="Armstrong W" first="William B." last="Armstrong">William B. Armstrong</name><affiliation wicri:level="2"><nlm:aff id="Aff1">Department of Otolaryngology – Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Bldg 56 Room 500, Orange, CA 92868 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Californie</region></placeName><wicri:cityArea>Department of Otolaryngology – Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Bldg 56 Room 500, Orange</wicri:cityArea></affiliation></author></analytic><series><title level="j">Lasers in Medical Science</title><idno type="ISSN">0268-8921</idno><idno type="eISSN">1435-604X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Transoral laser microsurgery (TLM) is an emerging technique for the management of laryngeal and other head and neck malignancies. It is increasingly being used in place of traditional open surgery because of lower morbidity and improved organ preservation. Since the surgery is performed from the inside working outward as opposed to working from the outside in, there is less damage to the supporting structures that lie external to the tumor. Coupling the laser to a micromanipulator and a microscope allows precise tissue cutting and hemostasis; thereby improving visualization and precise ablation. The basic approach and principles of performing TLM, the devices currently in use, and the associated dosimetry parameters will be discussed. The benefits of using TLM over conventional surgery, common complications and the different settings used depending on the location of the tumor will also be discussed. Although the CO<sub>2</sub> laser is the most versatile and the best-suited laser for TLM applications, a variety of lasers and different parameters are used in the treatment of laryngeal cancer. Improved instrumentation has lead to an increased utilization of TLM by head and neck cancer surgeons and has resulted in improved outcomes. 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uniqKey="Preuss S">SF Preuss</name></author><author><name sortKey="Cramer, K" uniqKey="Cramer K">K Cramer</name></author><author><name sortKey="Klussmann, Jp" uniqKey="Klussmann J">JP Klussmann</name></author><author><name sortKey="Eckel, He" uniqKey="Eckel H">HE Eckel</name></author><author><name sortKey="Guntinas Lichius, O" uniqKey="Guntinas Lichius O">O Guntinas-Lichius</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rosen, Ca" uniqKey="Rosen C">CA Rosen</name></author><author><name sortKey="Andrade Filho, Pa" uniqKey="Andrade Filho P">PA Andrade Filho</name></author><author><name sortKey="Scheffel, L" uniqKey="Scheffel L">L Scheffel</name></author><author><name sortKey="Buckmire, R" uniqKey="Buckmire R">R Buckmire</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Vilaseca Gonzalez, I" uniqKey="Vilaseca Gonzalez I">I Vilaseca-Gonzalez</name></author><author><name sortKey="Bernal Sprekelsen, M" uniqKey="Bernal Sprekelsen M">M Bernal-Sprekelsen</name></author><author><name sortKey="Blanch Alejandro, Jl" uniqKey="Blanch Alejandro J">JL Blanch-Alejandro</name></author><author><name sortKey="Moragas Lluis, M" uniqKey="Moragas Lluis M">M Moragas-Lluis</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pearson, Bw" uniqKey="Pearson B">BW Pearson</name></author><author><name sortKey="Salassa, Jr" uniqKey="Salassa J">JR Salassa</name></author><author><name sortKey="Hinni, Ml" uniqKey="Hinni M">ML Hinni</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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