title: Intraindividual comparison of 1,470 nm diode laser versus carbon dioxide laser for tonsillotomy: a prospective, randomized, double blind, controlled feasibility trial.
abstract: BACKGROUND
  The need for reduction of post-tonsillectomy hemorrhage has led to promotion of tonsillotomy techniques for tonsil tissue reduction in obstructive tonsillar hypertrophy. This trial compares ablative tissue effects using 1,470 nm diode laser and carbon dioxide laser for tonsillotomy in an intraindividual design.
  
  
  METHODS
  21 children aged 3-13 years (mean age 6.3 years) underwent laser tonsillotomy for obstructive tonsillar hypertrophy in this double blind, prospective, randomized, clinical feasibility trial. In each of the blinded patients, tonsillotomy was performed using fiber guided 1,470 nm diode laser (contact mode, 15 W power) on the one side and carbon dioxide laser (12 W power) on the other side. An independent, blinded physician documented clinical presentation and patients' symptoms preoperatively and on Days 1, 3, 7, 14, and 21 post-operatively using standardized questionnaire including VAS for each side separately.
  
  
  RESULTS
  The mean duration of operative treatment was 2.7 min using 1,470 nm laser and 4.9 min using carbon dioxide laser respectively. Intraoperative bleeding and the frequency of bipolar forceps use for intraoperative bleeding control was significantly less using 1,470 nm diode laser system. There was no difference in post-operative pain scores between the carbon dioxide laser treated and the 1,470 nm fiber guided diode laser treated side. No infections, hemorrhages or other complications occurred in the course of the 3 weeks post-operative period.
  
  
  CONCLUSIONS
  A fiber-guided 1,470 nm diode laser system offers an efficient and safe method for tonsillotomy as treatment of obstructive tonsillar hypertrophy. Compared to our standard practice (carbon dioxide laser), 1,470 nm laser application provides comparable tissue ablation effects with less intraoperative bleeding and shorter operation time.
authors: Department of Otorhinolaryngology, Head and Neck Surgery, University of Munich, Marchioninistr. 15, 81377 Munich, Germany. miriam.havel@med.uni-muenchen.de
authors: Miriam
authors: M
authors: Havel
authors: Ronald
authors: R
authors: Sroka
authors: Elsa
authors: E
authors: Englert
authors: Klaus
authors: K
authors: Stelter
authors: Andreas
authors: A
authors: Leunig
authors: Christian S
authors: CS
authors: Betz
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005240:Feasibility Studies; D006801:Humans; D006965:Hyperplasia / Q000601:surgery; D054020:Lasers, Gas / Q000627:therapeutic use*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D061646:Operative Time; D010149:Postoperative Pain; D014066:Palatine Tonsil / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome