title: A novel tool in laryngeal surgery: preliminary results of the picosecond infrared laser.
abstract: OBJECTIVE
  Conventional lasers ablate tissue through photothermal, photomechanical, and/or photoionizing effects, which may result in collateral tissue damage. The novel nonionizing picosecond infrared laser (PIRL) selectively energizes tissue water molecules using ultrafast pulses to drive ablation on timescales faster than energy transport to minimize collateral damage to adjacent cells.
  
  
  METHODS
  Animal cadaver study.
  
  
  METHODS
  Cuts in porcine laryngeal epithelium, lamina propria, and cartilage were made using PIRL and carbon dioxide (CO₂) laser. Lateral damage zones and cutting gaps were histologically compared.
  
  
  RESULTS
  The mean widths of epithelial (8.5 μm), subepithelial (10.9 μm), and cartilage damage zones (8.1 μm) were significantly lower for cuts made by PIRL compared with CO₂ laser (p < 0.001). Mean cutting gaps in vocal fold (174.7 μm) and epiglottic cartilage (56.3 μm) were significantly narrower for cuts made by PIRL compared with CO₂ laser (P < 0.01, P < 0.05).
  
  
  CONCLUSIONS
  PIRL ablation demonstrates superiority over CO₂ laser in cutting precision with less collateral tissue damage.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Max Planck Research Department for Structural Dynamics, University of Hamburg, Hamburg, Germany.
authors.forename: Arne
authors.initials: A
authors.lastname: Böttcher
authors.forename: Till S
authors.initials: TS
authors.lastname: Clauditz
authors.forename: Rainald
authors.initials: R
authors.lastname: Knecht
authors.forename: Stanislav
authors.initials: S
authors.lastname: Kucher
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wöllmer
authors.forename: Waldemar
authors.initials: W
authors.lastname: Wilczak
authors.forename: Peter
authors.initials: P
authors.lastname: Krötz
authors.forename: Nathan
authors.initials: N
authors.lastname: Jowett
authors.forename: Carsten V
authors.initials: CV
authors.lastname: Dalchow
authors.forename: Adrian
authors.initials: A
authors.lastname: Münscher
authors.forename: R J Dwayne
authors.initials: RJ
authors.lastname: Miller
mesh_terms: D000818:Animals; D007259:Infrared Rays / Q000627:therapeutic use; D007825:Laryngectomy / Q000379:methods*; D053685:Laser Therapy / Q000379:methods*; D054020:Lasers, Gas / Q000627:therapeutic use*; D013552:Swine
keywords: CO2; Larynx surgery; PIRL; damage zone; histology; laryngeal surgery; laser