Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry
Identifieur interne : 000405 ( Ncbi/Merge ); 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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<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>
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<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. Laser energy levels and spot size are adjusted to vary the precision of cutting and amount of hemostasis obtained.</p>
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<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Jemal, A" uniqKey="Jemal A">A Jemal</name>
</author>
<author><name sortKey="Siegel, R" uniqKey="Siegel R">R Siegel</name>
</author>
<author><name sortKey="Ward, E" uniqKey="Ward E">E Ward</name>
</author>
<author><name sortKey="Hao, Y" uniqKey="Hao Y">Y Hao</name>
</author>
<author><name sortKey="Xu, J" uniqKey="Xu J">J Xu</name>
</author>
<author><name sortKey="Murray, T" uniqKey="Murray T">T Murray</name>
</author>
<author><name sortKey="Thun, Mj" uniqKey="Thun M">MJ Thun</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Barnes, L" uniqKey="Barnes L">L Barnes</name>
</author>
<author><name sortKey="Tse, Lly" uniqKey="Tse L">LLY Tse</name>
</author>
<author><name sortKey="Hunt, Jl" uniqKey="Hunt J">JL Hunt</name>
</author>
<author><name sortKey="Brandwein Gensler, M" uniqKey="Brandwein Gensler M">M Brandwein-Gensler</name>
</author>
<author><name sortKey="Urken, M" uniqKey="Urken M">M Urken</name>
</author>
<author><name sortKey="Slootweg, P" uniqKey="Slootweg P">P Slootweg</name>
</author>
<author><name sortKey="Gale, N" uniqKey="Gale N">N Gale</name>
</author>
<author><name sortKey="Cardesa, A" uniqKey="Cardesa A">A Cardesa</name>
</author>
<author><name sortKey="Zidar, N" uniqKey="Zidar N">N Zidar</name>
</author>
<author><name sortKey="Boffetta, P" uniqKey="Boffetta P">P Boffetta</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hoffman, Ht" uniqKey="Hoffman H">HT Hoffman</name>
</author>
<author><name sortKey="Porter, K" uniqKey="Porter K">K Porter</name>
</author>
<author><name sortKey="Karnell, Lh" uniqKey="Karnell L">LH Karnell</name>
</author>
<author><name sortKey="Cooper, Js" uniqKey="Cooper J">JS Cooper</name>
</author>
<author><name sortKey="Weber, Rs" uniqKey="Weber R">RS Weber</name>
</author>
<author><name sortKey="Langer, Cj" uniqKey="Langer C">CJ Langer</name>
</author>
<author><name sortKey="Ang, Kk" uniqKey="Ang K">KK Ang</name>
</author>
<author><name sortKey="Gay, G" uniqKey="Gay G">G Gay</name>
</author>
<author><name sortKey="Stewart, A" uniqKey="Stewart A">A Stewart</name>
</author>
<author><name sortKey="Robinson, Ra" uniqKey="Robinson R">RA Robinson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Altieri, A" uniqKey="Altieri A">A Altieri</name>
</author>
<author><name sortKey="Garavello, W" uniqKey="Garavello W">W Garavello</name>
</author>
<author><name sortKey="Bosetti, C" uniqKey="Bosetti C">C Bosetti</name>
</author>
<author><name sortKey="Gallus, S" uniqKey="Gallus S">S Gallus</name>
</author>
<author><name sortKey="Vecchia, C" uniqKey="Vecchia C">C Vecchia</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Vecchia, C" uniqKey="Vecchia C">C Vecchia</name>
</author>
<author><name sortKey="Zhang, Zf" uniqKey="Zhang Z">ZF Zhang</name>
</author>
<author><name sortKey="Altieri, A" uniqKey="Altieri A">A Altieri</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Menvielle, G" uniqKey="Menvielle G">G Menvielle</name>
</author>
<author><name sortKey="Luce, D" uniqKey="Luce D">D Luce</name>
</author>
<author><name sortKey="Goldberg, P" uniqKey="Goldberg P">P Goldberg</name>
</author>
<author><name sortKey="Bugel, I" uniqKey="Bugel I">I Bugel</name>
</author>
<author><name sortKey="Leclerc, A" uniqKey="Leclerc A">A Leclerc</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Menvielle, G" uniqKey="Menvielle G">G Menvielle</name>
</author>
<author><name sortKey="Luce, D" uniqKey="Luce D">D Luce</name>
</author>
<author><name sortKey="Goldberg, P" uniqKey="Goldberg P">P Goldberg</name>
</author>
<author><name sortKey="Leclerc, A" uniqKey="Leclerc A">A Leclerc</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Pelucchi, C" uniqKey="Pelucchi C">C Pelucchi</name>
</author>
<author><name sortKey="Gallus, S" uniqKey="Gallus S">S Gallus</name>
</author>
<author><name sortKey="Garavello, W" uniqKey="Garavello W">W Garavello</name>
</author>
<author><name sortKey="Bosetti, C" uniqKey="Bosetti C">C Bosetti</name>
</author>
<author><name sortKey="Vecchia, C" uniqKey="Vecchia C">C Vecchia</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Qadeer, Ma" uniqKey="Qadeer M">MA Qadeer</name>
</author>
<author><name sortKey="Colabianchi, N" uniqKey="Colabianchi N">N Colabianchi</name>
</author>
<author><name sortKey="Vaezi, Mf" uniqKey="Vaezi M">MF Vaezi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Vaezi, Mf" uniqKey="Vaezi M">MF Vaezi</name>
</author>
<author><name sortKey="Qadeer, Ma" uniqKey="Qadeer M">MA Qadeer</name>
</author>
<author><name sortKey="Lopez, R" uniqKey="Lopez R">R Lopez</name>
</author>
<author><name sortKey="Colabianchi, N" uniqKey="Colabianchi N">N Colabianchi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Shangina, O" uniqKey="Shangina O">O Shangina</name>
</author>
<author><name sortKey="Brennan, P" uniqKey="Brennan P">P Brennan</name>
</author>
<author><name sortKey="Szeszenia Dabrowska, N" uniqKey="Szeszenia Dabrowska N">N Szeszenia-Dabrowska</name>
</author>
<author><name sortKey="Mates, D" uniqKey="Mates D">D Mates</name>
</author>
<author><name sortKey="Fabianova, E" uniqKey="Fabianova E">E Fabianova</name>
</author>
<author><name sortKey="Fletcher, T" uniqKey="Fletcher T">T Fletcher</name>
</author>
<author><name sortKey="T Annetje, A" uniqKey="T Annetje A">A t’Mannetje</name>
</author>
<author><name sortKey="Boffetta, P" uniqKey="Boffetta P">P Boffetta</name>
</author>
<author><name sortKey="Zaridze, D" uniqKey="Zaridze D">D Zaridze</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Berrino, F" uniqKey="Berrino F">F Berrino</name>
</author>
<author><name sortKey="Richiardi, L" uniqKey="Richiardi L">L Richiardi</name>
</author>
<author><name sortKey="Boffetta, P" uniqKey="Boffetta P">P Boffetta</name>
</author>
<author><name sortKey="Esteve, J" uniqKey="Esteve J">J Esteve</name>
</author>
<author><name sortKey="Belletti, I" uniqKey="Belletti I">I Belletti</name>
</author>
<author><name sortKey="Raymond, L" uniqKey="Raymond L">L Raymond</name>
</author>
<author><name sortKey="Troschel, L" uniqKey="Troschel L">L Troschel</name>
</author>
<author><name sortKey="Pisani, P" uniqKey="Pisani P">P Pisani</name>
</author>
<author><name sortKey="Zubiri, L" uniqKey="Zubiri L">L Zubiri</name>
</author>
<author><name sortKey="Ascunce, N" uniqKey="Ascunce N">N Ascunce</name>
</author>
<author><name sortKey="Guberan, E" uniqKey="Guberan E">E Guberan</name>
</author>
<author><name sortKey="Tuyns, A" uniqKey="Tuyns A">A Tuyns</name>
</author>
<author><name sortKey="Terracini, B" uniqKey="Terracini B">B Terracini</name>
</author>
<author><name sortKey="Merletti, F" uniqKey="Merletti F">F Merletti</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Fakhry, C" uniqKey="Fakhry C">C Fakhry</name>
</author>
<author><name sortKey="Gillison, Ml" uniqKey="Gillison M">ML Gillison</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ragin, Cc" uniqKey="Ragin C">CC Ragin</name>
</author>
<author><name sortKey="Modugno, F" uniqKey="Modugno F">F Modugno</name>
</author>
<author><name sortKey="Gollin, Sm" uniqKey="Gollin S">SM Gollin</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Schlecht, Nf" uniqKey="Schlecht N">NF Schlecht</name>
</author>
<author><name sortKey="Burk, Rd" uniqKey="Burk R">RD Burk</name>
</author>
<author><name sortKey="Adrien, L" uniqKey="Adrien L">L Adrien</name>
</author>
<author><name sortKey="Dunne, A" uniqKey="Dunne A">A Dunne</name>
</author>
<author><name sortKey="Kawachi, N" uniqKey="Kawachi N">N Kawachi</name>
</author>
<author><name sortKey="Sarta, C" uniqKey="Sarta C">C Sarta</name>
</author>
<author><name sortKey="Chen, Q" uniqKey="Chen Q">Q Chen</name>
</author>
<author><name sortKey="Brandwein Gensler, M" uniqKey="Brandwein Gensler M">M Brandwein-Gensler</name>
</author>
<author><name sortKey="Prystowsky, Mb" uniqKey="Prystowsky M">MB Prystowsky</name>
</author>
<author><name sortKey="Childs, G" uniqKey="Childs G">G Childs</name>
</author>
<author><name sortKey="Smith, Rv" uniqKey="Smith R">RV Smith</name>
</author>
<author><name sortKey="Belbin, Tj" uniqKey="Belbin T">TJ Belbin</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Copper, Mp" uniqKey="Copper M">MP Copper</name>
</author>
<author><name sortKey="Jovanovic, A" uniqKey="Jovanovic A">A Jovanovic</name>
</author>
<author><name sortKey="Nauta, Jj" uniqKey="Nauta J">JJ Nauta</name>
</author>
<author><name sortKey="Braakhuis, Bj" uniqKey="Braakhuis B">BJ Braakhuis</name>
</author>
<author><name sortKey="Vries, N" uniqKey="Vries N">N Vries</name>
</author>
<author><name sortKey="Waal, I" uniqKey="Waal I">I Waal</name>
</author>
<author><name sortKey="Snow, Gb" uniqKey="Snow G">GB Snow</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Armstrong, Wb" uniqKey="Armstrong W">WB Armstrong</name>
</author>
<author><name sortKey="Netterville, Jl" uniqKey="Netterville J">JL Netterville</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Merati, Al" uniqKey="Merati A">AL Merati</name>
</author>
<author><name sortKey="Rieder, Aa" uniqKey="Rieder A">AA Rieder</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Noordzij, Jp" uniqKey="Noordzij J">JP Noordzij</name>
</author>
<author><name sortKey="Ossoff, Rh" uniqKey="Ossoff R">RH Ossoff</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Ogura, Jh" uniqKey="Ogura J">JH Ogura</name>
</author>
<author><name sortKey="Thawley, Se" uniqKey="Thawley S">SE Thawley</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ogura, Jh" uniqKey="Ogura J">JH Ogura</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Tufano, Rp" uniqKey="Tufano R">RP Tufano</name>
</author>
<author><name sortKey="Stafford, Em" uniqKey="Stafford E">EM Stafford</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ambrosch, P" uniqKey="Ambrosch P">P Ambrosch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cortesina, G" uniqKey="Cortesina G">G Cortesina</name>
</author>
<author><name sortKey="Stefani, A" uniqKey="Stefani A">A Stefani</name>
</author>
<author><name sortKey="Cavalot, A" uniqKey="Cavalot A">A Cavalot</name>
</author>
<author><name sortKey="Albera, R" uniqKey="Albera R">R Albera</name>
</author>
<author><name sortKey="Rosso, P" uniqKey="Rosso P">P Rosso</name>
</author>
<author><name sortKey="Bussi, M" uniqKey="Bussi M">M Bussi</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Wolf, Gt" uniqKey="Wolf G">GT Wolf</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Sadri, M" uniqKey="Sadri M">M Sadri</name>
</author>
<author><name sortKey="Mcmahon, J" uniqKey="Mcmahon J">J McMahon</name>
</author>
<author><name sortKey="Parker, A" uniqKey="Parker A">A Parker</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Forastiere, Aa" uniqKey="Forastiere A">AA Forastiere</name>
</author>
<author><name sortKey="Goepfert, H" uniqKey="Goepfert H">H Goepfert</name>
</author>
<author><name sortKey="Maor, M" uniqKey="Maor M">M Maor</name>
</author>
<author><name sortKey="Pajak, Tf" uniqKey="Pajak T">TF Pajak</name>
</author>
<author><name sortKey="Weber, R" uniqKey="Weber R">R Weber</name>
</author>
<author><name sortKey="Morrison, W" uniqKey="Morrison W">W Morrison</name>
</author>
<author><name sortKey="Glisson, B" uniqKey="Glisson B">B Glisson</name>
</author>
<author><name sortKey="Trotti, A" uniqKey="Trotti A">A Trotti</name>
</author>
<author><name sortKey="Ridge, Ja" uniqKey="Ridge J">JA Ridge</name>
</author>
<author><name sortKey="Chao, C" uniqKey="Chao C">C Chao</name>
</author>
<author><name sortKey="Peters, G" uniqKey="Peters G">G Peters</name>
</author>
<author><name sortKey="Lee, Dj" uniqKey="Lee D">DJ Lee</name>
</author>
<author><name sortKey="Leaf, A" uniqKey="Leaf A">A Leaf</name>
</author>
<author><name sortKey="Ensley, J" uniqKey="Ensley J">J Ensley</name>
</author>
<author><name sortKey="Cooper, J" uniqKey="Cooper J">J Cooper</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Machtay, M" uniqKey="Machtay M">M Machtay</name>
</author>
<author><name sortKey="Rosenthal, Di" uniqKey="Rosenthal D">DI Rosenthal</name>
</author>
<author><name sortKey="Hershock, D" uniqKey="Hershock D">D Hershock</name>
</author>
<author><name sortKey="Jones, H" uniqKey="Jones H">H Jones</name>
</author>
<author><name sortKey="Williamson, S" uniqKey="Williamson S">S Williamson</name>
</author>
<author><name sortKey="Greenberg, Mj" uniqKey="Greenberg M">MJ Greenberg</name>
</author>
<author><name sortKey="Weinstein, Gs" uniqKey="Weinstein G">GS Weinstein</name>
</author>
<author><name sortKey="Aviles, Vm" uniqKey="Aviles V">VM Aviles</name>
</author>
<author><name sortKey="Chalian, Aa" uniqKey="Chalian A">AA Chalian</name>
</author>
<author><name sortKey="Weber, Rs" uniqKey="Weber R">RS Weber</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Agrawal, N" uniqKey="Agrawal N">N Agrawal</name>
</author>
<author><name sortKey="Goldenberg, D" uniqKey="Goldenberg D">D Goldenberg</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Jackson, C" uniqKey="Jackson C">C Jackson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Strong, Ms" uniqKey="Strong M">MS Strong</name>
</author>
<author><name sortKey="Jako, Gj" uniqKey="Jako G">GJ Jako</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Strong, Ms" uniqKey="Strong M">MS Strong</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Vaughan, Cw" uniqKey="Vaughan C">CW Vaughan</name>
</author>
<author><name sortKey="Strong, Ms" uniqKey="Strong M">MS Strong</name>
</author>
<author><name sortKey="Jako, Gj" uniqKey="Jako G">GJ Jako</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Steiner, W" uniqKey="Steiner W">W Steiner</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Steiner, W" uniqKey="Steiner W">W Steiner</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Steiner, W" uniqKey="Steiner W">W Steiner</name>
</author>
<author><name sortKey="Ambrosch, P" uniqKey="Ambrosch P">P Ambrosch</name>
</author>
<author><name sortKey="Hess, Cf" uniqKey="Hess C">CF Hess</name>
</author>
<author><name sortKey="Kron, M" uniqKey="Kron M">M Kron</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Steiner, W" uniqKey="Steiner W">W Steiner</name>
</author>
<author><name sortKey="Fierek, O" uniqKey="Fierek O">O Fierek</name>
</author>
<author><name sortKey="Ambrosch, P" uniqKey="Ambrosch P">P Ambrosch</name>
</author>
<author><name sortKey="Hommerich, Cp" uniqKey="Hommerich C">CP Hommerich</name>
</author>
<author><name sortKey="Kron, M" uniqKey="Kron M">M Kron</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Grant, Dg" uniqKey="Grant D">DG Grant</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>
<author><name sortKey="Pearson, Bw" uniqKey="Pearson B">BW Pearson</name>
</author>
<author><name sortKey="Hayden, Re" uniqKey="Hayden R">RE Hayden</name>
</author>
<author><name sortKey="Perry, Wc" uniqKey="Perry W">WC Perry</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hinni, Ml" uniqKey="Hinni M">ML Hinni</name>
</author>
<author><name sortKey="Salassa, Jr" uniqKey="Salassa J">JR Salassa</name>
</author>
<author><name sortKey="Grant, Dg" uniqKey="Grant D">DG Grant</name>
</author>
<author><name sortKey="Pearson, Bw" uniqKey="Pearson B">BW Pearson</name>
</author>
<author><name sortKey="Hayden, Re" uniqKey="Hayden R">RE Hayden</name>
</author>
<author><name sortKey="Martin, A" uniqKey="Martin A">A Martin</name>
</author>
<author><name sortKey="Christiansen, H" uniqKey="Christiansen H">H Christiansen</name>
</author>
<author><name sortKey="Haughey, Bh" uniqKey="Haughey B">BH Haughey</name>
</author>
<author><name sortKey="Nussenbaum, B" uniqKey="Nussenbaum B">B Nussenbaum</name>
</author>
<author><name sortKey="Steiner, W" uniqKey="Steiner W">W Steiner</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Grant, Dg" uniqKey="Grant D">DG Grant</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>
<author><name sortKey="Pearson, Bw" uniqKey="Pearson B">BW Pearson</name>
</author>
<author><name sortKey="Hayden, Re" uniqKey="Hayden R">RE Hayden</name>
</author>
<author><name sortKey="Perry, Wc" uniqKey="Perry W">WC Perry</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Grant, Dg" uniqKey="Grant D">DG Grant</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>
<author><name sortKey="Pearson, Bw" uniqKey="Pearson B">BW Pearson</name>
</author>
<author><name sortKey="Hayden, Re" uniqKey="Hayden R">RE Hayden</name>
</author>
<author><name sortKey="Perry, Wc" uniqKey="Perry W">WC Perry</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cabanillas, R" uniqKey="Cabanillas R">R Cabanillas</name>
</author>
<author><name sortKey="Rodrigo, Jp" uniqKey="Rodrigo J">JP Rodrigo</name>
</author>
<author><name sortKey="Llorente, Jl" uniqKey="Llorente J">JL Llorente</name>
</author>
<author><name sortKey="Suarez, V" uniqKey="Suarez V">V Suarez</name>
</author>
<author><name sortKey="Ortega, P" uniqKey="Ortega P">P Ortega</name>
</author>
<author><name sortKey="Suarez, C" uniqKey="Suarez C">C Suarez</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zeitels, Sm" uniqKey="Zeitels S">SM Zeitels</name>
</author>
<author><name sortKey="Burns, Ja" uniqKey="Burns J">JA Burns</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zeitels, Sm" uniqKey="Zeitels S">SM Zeitels</name>
</author>
<author><name sortKey="Burns, Ja" uniqKey="Burns J">JA Burns</name>
</author>
<author><name sortKey="Lopez Guerra, G" uniqKey="Lopez Guerra G">G Lopez-Guerra</name>
</author>
<author><name sortKey="Anderson, Rr" uniqKey="Anderson R">RR Anderson</name>
</author>
<author><name sortKey="Hillman, Re" uniqKey="Hillman R">RE Hillman</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Cabanillas, R" uniqKey="Cabanillas R">R Cabanillas</name>
</author>
<author><name sortKey="Ortega, C" uniqKey="Ortega C">C Ortega</name>
</author>
<author><name sortKey="Rodrigo, Jp" uniqKey="Rodrigo J">JP Rodrigo</name>
</author>
<author><name sortKey="Llorente, Jl" uniqKey="Llorente J">JL Llorente</name>
</author>
<author><name sortKey="Ortega, P" uniqKey="Ortega P">P Ortega</name>
</author>
<author><name sortKey="Suarez, C" uniqKey="Suarez C">C Suarez</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Devaiah, Ak" uniqKey="Devaiah A">AK Devaiah</name>
</author>
<author><name sortKey="Shapshay, Sm" uniqKey="Shapshay S">SM Shapshay</name>
</author>
<author><name sortKey="Desai, U" uniqKey="Desai U">U Desai</name>
</author>
<author><name sortKey="Shapira, G" uniqKey="Shapira G">G Shapira</name>
</author>
<author><name sortKey="Weisberg, O" uniqKey="Weisberg O">O Weisberg</name>
</author>
<author><name sortKey="Torres, Ds" uniqKey="Torres D">DS Torres</name>
</author>
<author><name sortKey="Wang, Z" uniqKey="Wang Z">Z Wang</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jacobson, As" uniqKey="Jacobson A">AS Jacobson</name>
</author>
<author><name sortKey="Woo, P" uniqKey="Woo P">P Woo</name>
</author>
<author><name sortKey="Shapshay, Sm" uniqKey="Shapshay S">SM Shapshay</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zeitels, Sm" uniqKey="Zeitels S">SM Zeitels</name>
</author>
<author><name sortKey="Akst, Lm" uniqKey="Akst L">LM Akst</name>
</author>
<author><name sortKey="Burns, Ja" uniqKey="Burns J">JA Burns</name>
</author>
<author><name sortKey="Hillman, Re" uniqKey="Hillman R">RE Hillman</name>
</author>
<author><name sortKey="Broadhurst, Ms" uniqKey="Broadhurst M">MS Broadhurst</name>
</author>
<author><name sortKey="Anderson, Rr" uniqKey="Anderson R">RR Anderson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ossoff, Rh" uniqKey="Ossoff R">RH Ossoff</name>
</author>
<author><name sortKey="Garrett, Cg" uniqKey="Garrett C">CG Garrett</name>
</author>
<author><name sortKey="Reinisch, L" uniqKey="Reinisch L">L Reinisch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Philipp, Cm" uniqKey="Philipp C">CM Philipp</name>
</author>
<author><name sortKey="Berlien, Hp" uniqKey="Berlien H">HP Berlien</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Koufman, Ja" uniqKey="Koufman J">JA Koufman</name>
</author>
<author><name sortKey="Rees, Cj" uniqKey="Rees C">CJ Rees</name>
</author>
<author><name sortKey="Frazier, Wd" uniqKey="Frazier W">WD Frazier</name>
</author>
<author><name sortKey="Kilpatrick, La" uniqKey="Kilpatrick L">LA Kilpatrick</name>
</author>
<author><name sortKey="Wright, Sc" uniqKey="Wright S">SC Wright</name>
</author>
<author><name sortKey="Halum, Sl" uniqKey="Halum S">SL Halum</name>
</author>
<author><name sortKey="Postma, Gn" uniqKey="Postma G">GN Postma</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ossoff, Rh" uniqKey="Ossoff R">RH Ossoff</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Steiner, W" uniqKey="Steiner W">W Steiner</name>
</author>
<author><name sortKey="Ambrosch, P" uniqKey="Ambrosch P">P Ambrosch</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Eckel, He" uniqKey="Eckel H">HE Eckel</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Rudert, Hh" uniqKey="Rudert H">HH Rudert</name>
</author>
<author><name sortKey="Werner, Ja" uniqKey="Werner J">JA Werner</name>
</author>
<author><name sortKey="Hoft, S" uniqKey="Hoft S">S Hoft</name>
</author>
</analytic>
</biblStruct>
<biblStruct></biblStruct>
<biblStruct><analytic><author><name sortKey="Fisher, Jc" uniqKey="Fisher J">JC Fisher</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Remacle, M" uniqKey="Remacle M">M Remacle</name>
</author>
<author><name sortKey="Lawson, G" uniqKey="Lawson G">G Lawson</name>
</author>
<author><name sortKey="Nollevaux, Mc" uniqKey="Nollevaux M">MC Nollevaux</name>
</author>
<author><name sortKey="Delos, M" uniqKey="Delos M">M Delos</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Steiner, W" uniqKey="Steiner W">W Steiner</name>
</author>
<author><name sortKey="Ambrosch, P" uniqKey="Ambrosch P">P Ambrosch</name>
</author>
<author><name sortKey="Rodel, Rm" uniqKey="Rodel R">RM Rodel</name>
</author>
<author><name sortKey="Kron, M" uniqKey="Kron M">M Kron</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Manola, M" uniqKey="Manola M">M Manola</name>
</author>
<author><name sortKey="Moscillo, L" uniqKey="Moscillo L">L Moscillo</name>
</author>
<author><name sortKey="Costa, G" uniqKey="Costa G">G Costa</name>
</author>
<author><name sortKey="Barillari, U" uniqKey="Barillari U">U Barillari</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Jackel, Mc" uniqKey="Jackel M">MC Jackel</name>
</author>
<author><name sortKey="Martin, A" uniqKey="Martin A">A Martin</name>
</author>
<author><name sortKey="Steiner, W" uniqKey="Steiner W">W Steiner</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Corvo, Ma" uniqKey="Corvo M">MA Corvo</name>
</author>
<author><name sortKey="Inacio, A" uniqKey="Inacio A">A Inacio</name>
</author>
<author><name sortKey="Mello, Mb" uniqKey="Mello M">MB Mello</name>
</author>
<author><name sortKey="Eckley, Ca" uniqKey="Eckley C">CA Eckley</name>
</author>
<author><name sortKey="Duprat Ade, C" uniqKey="Duprat Ade C">C Duprat Ade</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Klussmann, Jp" uniqKey="Klussmann J">JP Klussmann</name>
</author>
<author><name sortKey="Knoedgen, R" uniqKey="Knoedgen R">R Knoedgen</name>
</author>
<author><name sortKey="Wittekindt, C" uniqKey="Wittekindt C">C Wittekindt</name>
</author>
<author><name sortKey="Damm, M" uniqKey="Damm M">M Damm</name>
</author>
<author><name sortKey="Eckel, He" uniqKey="Eckel H">HE Eckel</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Preuss, Sf" 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>
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<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Lasers Med Sci</journal-id>
<journal-title-group><journal-title>Lasers in Medical Science</journal-title>
</journal-title-group>
<issn pub-type="ppub">0268-8921</issn>
<issn pub-type="epub">1435-604X</issn>
<publisher><publisher-name>Springer-Verlag</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">20835840</article-id>
<article-id pub-id-type="pmc">2981737</article-id>
<article-id pub-id-type="publisher-id">834</article-id>
<article-id pub-id-type="doi">10.1007/s10103-010-0834-5</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Transoral laser microsurgery for laryngeal cancer: A primer and review of laser dosimetry</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Rubinstein</surname>
<given-names>Marc</given-names>
</name>
<xref ref-type="aff" rid="Aff1">1</xref>
<xref ref-type="aff" rid="Aff2">2</xref>
</contrib>
<contrib contrib-type="author" corresp="yes"><name><surname>Armstrong</surname>
<given-names>William B.</given-names>
</name>
<address><phone>+1-714-4565750</phone>
<fax>+1-714-4565747</fax>
<email>wbarmstr@uci.edu</email>
</address>
<xref ref-type="aff" rid="Aff1">1</xref>
</contrib>
<aff id="Aff1"><label>1</label>
Department of Otolaryngology – Head and Neck Surgery, University of California Irvine, 101 The City Drive S, Bldg 56 Room 500, Orange, CA 92868 USA</aff>
<aff id="Aff2"><label>2</label>
Beckman Laser Institute and Medical Clinic, University of California Irvine, Irvine, CA USA</aff>
</contrib-group>
<pub-date pub-type="epub"><day>11</day>
<month>9</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>11</day>
<month>9</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="ppub"><month>1</month>
<year>2011</year>
</pub-date>
<volume>26</volume>
<issue>1</issue>
<fpage>113</fpage>
<lpage>124</lpage>
<history><date date-type="received"><day>2</day>
<month>12</month>
<year>2009</year>
</date>
<date date-type="accepted"><day>13</day>
<month>8</month>
<year>2010</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s) 2010</copyright-statement>
</permissions>
<abstract><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. Laser energy levels and spot size are adjusted to vary the precision of cutting and amount of hemostasis obtained.</p>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>Laser</kwd>
<kwd>Microsurgery</kwd>
<kwd>Laryngeal cancer</kwd>
<kwd>CO<sub>2</sub>
</kwd>
<kwd>Endoscope</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© Springer-Verlag London Ltd 2011</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Californie</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Californie"><name sortKey="Rubinstein, Marc" sort="Rubinstein, Marc" uniqKey="Rubinstein M" first="Marc" last="Rubinstein">Marc Rubinstein</name>
</region>
<name sortKey="Armstrong, William B" sort="Armstrong, William B" uniqKey="Armstrong W" first="William B." last="Armstrong">William B. Armstrong</name>
<name sortKey="Rubinstein, Marc" sort="Rubinstein, Marc" uniqKey="Rubinstein M" first="Marc" last="Rubinstein">Marc Rubinstein</name>
</country>
</tree>
</affiliations>
</record>
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