ENT_Videos

A.R.C. Laser

A Step in the Right Direction

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Endonasal Surgery

Turbinectomy

Turbinectomy is aimed to reduce hypertrophic turbinates tissue, which reduce congestion and help restoring normal breathing.
Infrared laser radiation effectively absorbs in the mucosa and causes mild coagulation,  subsequently lead to superficial scarring at the submucosa and at the mucosal epithelium, all of which reduces excess secretion and swelling.
SYNECHIAE, STENOSIS IN ENDONASAL STRUCTURES  is a adhesion of two tissue layers,  a turbinate adhesion with the nasal septum is a frequent condition.
CONCHA BULLOSA  is a bubble like enlargement of the middle turbinate, also called nasal hyperplasia. This condition leads to difficulty in breathing, which may be improved by reducing the turbinate volume.
TURBINATE HYPERTROPHY OR HYPERPLASIA  is a permanent swelling condition of the nasal mucosa,  main causes are repeated infections, allergies or excessive use of nasal decongestion sprays.

Turbinectomy

Turbinate Reduction

Turbinectomy

Concha nasalis inferior both sides and post OP

Septoplasty • Septal Spur Ablation

A deviated septum or a septum deformation leads to a narrowing of the nasal cavity.  Such deformation of the nasal septum often occurs as a consequence of turbinate hyperplasia. Symptoms of deformation may be breathing impairment, olfactory disorders or nosebleeds. A straightening of the nasal septum by means of laser radiation can relieve the symptoms.
SEPTUM RESECTION / SEPTOPLASTY   in the area of the nostrils, an incision is made through the mucous membrane of the front edge of the nasal septum cartilage.
  Loosen the mucosa of bone and cartilage.
  Remove the excessive portions of the nasal septum.
  Straighten the nasal septum, insert stabilizing films.
  The fiber must be directly in contact with the tissue to achieve the desired effect.

Septoplasty

 Done with 300 μm and 600 μm fibers.
 Continuous laser wave typically 3-8 watt.

Septal Spur Ablation

 Shown here with 600 μm fiber.
 Continuous laser wave typically 6-8 watt.

Septoplasty

 Shown here with 300 μm fiber.
 Continuous laser wave typically 4 watt.

Sinus Surgery

Polypectomy • Epistaxis

Where medication and supportive therapy methods do not help recover chronically inflamed sinuses any longer, a surgical enlargement of the paranasal sinuses is indispensable. Laser radiation allows a sufficient enlargement of the para-nasal sinuses and a lasting relief of breathing.
HEREDITARY HEMORRHAGIC TELANGIECTASIA , also known as Osler-Weber-Rendu disease, is an autosomal dominant hereditary disease, which leads to abnormal blood vessel formation (vasodilation). The enlarged capillaries may occur anywhere, but they are mainly located in the nose, the mouth, on the face or in the mucous membranes of the gastrointestinal tract. They often appear as pinhead to rice-sized red spots on the skin and mucous membranes.  Such abnormally formed blood vessels may easily rupture and lead to bleeding, which may have serious consequences and may even cause anemia.  The aim of the laser treatment is a removal of potential sources of bleeding.
CYSTS, MUCOCELES  is a long-term accumulation of mucus in the para nasal sinuses. This is caused by the closure of the excretory duct of a sinus. Through the resulting pressure, the sinus wall may become deformed and become so large that there is a break into the eye cavity and the eyeball is displaced forward, thereby impairing vision.
TUBOPLASTY OF THE EUSTACHIAN TUBE –  In about 1% of the population, there is a dysfunction of the middle ear pressure equalization. To those affected, this means problems when flying, scuba diving or a permanent feeling of pressure on the ears. The result is a „dull“ feeling of hearing which is caused by a tubal ventilation disorder (obstructive tube dysfunction). Such dysfunction may result in a chronic middle ear infection and, in the worst case, lead to a permanent hearing loss. The treatment concept of Laser Eustachian Tuboplasty and Microdebrider Eustachian Tuboplasty provides for an extension of the pharyngeal opening of the auditory tube.

Polypectomy

POLYPECTOMY –  Nasal polyps are mucosal protrusions in the area of the main nasal cavity, which originate in the sinuses and consist of soft and edematous (filled with liquid) connective tissue.
These exact cause is unclear but ongoing inflammation is likely to trigger polyp formation. Polyps lead to nasal constriction and a watery discharge, resulting in disturbances of breathing and olfaction.
The aim of the polypectomy is to reestablish the physiological functions of the nose.

Nosebleeds Treatment

NOSEBLEEDS – Bleeding from the nose usually occurs through injury of small blood vessels or an extensive mucosal bleeding in the nasal cavity. Such bleeding is mostly located at the Locus Kiesselbachi (transition of the nasal vestibule to main nasal cavity) because this is the area with most vessels in the front nose area, or posterior to the rear lateral nasal wall. Such bleeding may be triggered by mechanical manipulation, an increase in the pressure in the vessels, climatic factors, infections, vascular malformations, trauma or by blood clotting disorders. The desired effect of the nosebleeds laser treatment is an obliteration of the vessels by means of photocoagulation.

Pharynx

LAUP • Cryptolysis

In many diseases occurring in the throat and pharynx area there are various malignant tumors, which may often arise as a result of excessive smoking/  alcohol abuse or insufficient oral hygiene …… 20% of cases reported, the cause is unclear though. An example of this is the lymphoepithelial nasopharyngeal carcinoma the Epstein-Barr viruses (EBV) are involved in. In oropharyngeal carcinomas however, human papilloma viruses (HPV viruses) (see papilloma excision) play a crucial role. The involvement of viruses does not automatically mean that patients are contagious for their environment. Through the contact process all malformations or proliferations should be resected. There is no guarantee for the non-recurrence of tumors.
TONSILLECTOMY – The tonsils form the lymphatic throat ring and serve to defend the immune system. The tonsils should be removed, when chronic tonsillitis or in case of an enlargement of the tonsils (in children). In order to eliminate the usual disease symptoms such as respiratory obstruction or swallowing problems.

cryptolysis_png   

LAUP

UVULOPALATOPLASTY (LAUP) –  Laser assisted uvulopalatoplasty is applied in the treatment of primary snoring and in the treatment of sleep breathing disorder with obstruction of the upper respiratory tract, which may trigger a sleep apnea with life threatening consequences. In uvulopalatoplasty which is mostly an outpatient procedure, the uvula is shortened or removed or the soft palate is tightened by means of laser radiation. The excessive soft tissue of the soft palate is removed. This method is often used as a surgical treatment when snoring, in the presence of an enlargement of the uvula. Breathing noise can thus be reduced and snoring can be eliminated.

Cryptolysis

TONSILLOTOMY (CF. TONSILLECTOMY) – Tonsillotomy is the partial resection of the palatine tonsils. As with tonsillectomy, the main focus lies with the reduction of infections and persistent dysphagia, particularly in children aged 3 to 6 years. In order not to turn off the entire immune system, a shrinkage of the tonsils with a removal of lymphoid tissue should be preferred to tonsillectomy.

Middle Ear Surgery

Stapedotomy • Stapedectomy

stapedectomy_s

STAPEDECTOMY –  This type of micro-invasive surgery is aimed at improving the hearing performance, which has been impaired by age-related otosclerosis where the ring band – the stapes is suspended to ossifies, and therefore can no
longer move, which leads to a conductive hearing loss.The upper part of the stapes is removed and replaced with an implant, which is attached to the anvil in order to restore the sound conduction to the inner ear. This is frequently made in case of otosclerosis where the ring band – the stapes is suspended to – ossifies, and therefore can no longer move, which leads to a conductive hearing loss. The upper part of the stapes is removed and replaced by a prosthesis (piston) which is anchored by means of laser footplate perforation and connected to the anvil.stapedotomy_s
STAPEDOTOMY –  In contrast to stapedectomy, stapedotomy refers to the removal of a part of the stapes bone. The treatment is carried out in the same way as in stapedectomy, i.e. by inserting a prosthesis, such as KURZ Medical’s NiTiBOND®.

Stapedotomy

Stapedotomy (full length)

Granulomectomy • Myringotomy  • Tympanoplasty

Microsurgery of the ear, laser applications open up new treatment alternatives. These includes opening of the eardrum and the support for the use of ossicle prostheses as well as the improvement of the hearing performance through cochlear implants. The use of a suitable laser even allows the uncomplicated removal of malignant and benign tumors in the middle ear.
GRANULOMECTOMY  is an inflammation-related, nodular tissue formation arising from epitheloid cells, mononuclear cells or giant cells. In most cases, the tumor occurs individually only with a diameter of 10-30 mm with a sharp demarcation between the affected and healthy tissue. The surface of the granuloma is crusty and fissured, as granulomas easily ooz or bleed. The desired effect of the laser treatment is complete elimination of the granuloma.
MYRINGOTOMY  is a surgical procedure in which a tiny incision is created in the eardrum (tympanic membrane) to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear.  Incision is done at the inferior section of the tympanic membrane, typical incisions sizes are:  Infants 1.4 to 1.6mm  •  Children 1.6 to 2.0mm  •  Adults 1.8 to 2.2mm
Procedure is suitable for:
  •  Adults who need short term ventilation
  •  Children with SOM without reactions who need short term ventilation
  •  General need for short term middle ear ventilation
  •  Patients who want to avoid general anesthesia
Without tube insertion, the incision usually heals spontaneously in two to three weeks  with tube insertion, the tube is either naturally extruded in 6 to 12 months or removed during a minor procedure.

Myringotomy

This case is of a 6yrs female diagnosed with recurrent Tonsillitis, Adenoid hypertrophy and bilateral OME.
Using a diode laser for Myringotomy have multiple advantages such as:
 Improved precision
 Bloodless procedure
 No post op pain
 Faster healing, typically laser Myringotomy will close after about one month.

Oral Surgery

Oral Fibroma Excision

In addition to diseases of the throat and neck area, the oral cavity may also be affected by undifferentiated cell growth, which may ultimately take the form of tumors. There are various forms of discomfort in this case which depend on locality, range from difficulties swallowing, hoarseness, to chronic pain.
TUMOR RESECTIONOral cavity tumors may occur throughout the entire oral mucosa. This may include the lips, anterior palatine arch, and palate, floor of the mouth, tongue and vermilion border. Most tumors are based on the mucosa that arises from epithelial cells. The aim of laser treatment is the complete tumor resection in the oral cavity without damaging the tissue around it.

Oral Fibroma Excision

Have a question? Contact us: 1800.654.0246

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