Dr. Karsten Schramm Profile

Dr. Karsten Schramm

at Univ Aachen Hospital

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Proceedings Article | 25 April 2005 Paper

Feasibility of coblation versus laser resection in recurrent nasal polyps

Justus Ilgner, Karsten Schramm, Philip Duwel, Andreas Donner, Martin Westhofen

Proceedings Volume 5686, (2005) https://doi.org/10.1117/12.591067

KEYWORDS: Surgery, Laser therapeutics, Tissues, Nd:YAG lasers, Laser ablation, Continuous wave operation, Laser tissue interaction, Laser vision correction, Safety, Negative feedback

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Introduction: Chronic sinusitis with nasal polyps is one of the commonest diseases of the upper airways, with a recurrence rate of about 15%. Minimally-invasive endoscopic laser procedures have been established to reduce the need for conventional revision surgery whenever medical follow-up fails. However, laser surgery requires special considerations for surgical, safety and economic aspects. This study evaluates the feasibility of coblation versus laser resection for recurrent nasal polyps. Material and methods: 6 nasal polyps were harvested each from the ostiomeatal complex of patients undergoing microscopic endonasal surgery for chronic sinusitis. 3 were dissected using a Neodymium:YAG laser system (Dornier MediLas 5060N) set at 10, 20 and 30w in cw mode with a 600μm bare fiber in contact mode with negative feedback power control, while further 3 polyps were dissected using a Coblation system (ArthroCare® Coblator® I) with a 30° angled and a 0° straight probe with 2.4 mm outer diameter. The specimens were examined histologically for carbonization and coagulation as well as unaltered tissue. Results: Laser resection resulted in a carbonization zone of 30μm in depth plus a coagulation zone of about 100μm, depending on the water content and type of tissue. While the carbonization zone was smaller with coblation, coagulation zones were comparable, leaving ample amount of unaltered tissue available for further diagnosis. Conclusion: Both resection techniques are generally feasible to be used in day case surgery for recurrent polyps. While the coblation system required no special safety requirements, accessibility of the sinuses was limited by the rigidity of applicators that are available.

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