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Comparative histology study of the vocal folds after incision with cold instruments and CO2 laser in an animal model

Among the several types of lasers employed in medicine today, the CO2 is the most widely used in otorhinolaryngology and head and neck surgeries. The advantages of its use are: the reduction in bleeding, reduction in post-operative edema and the easy access to the operation site, among others. Ever since Jako and Strong's works in 1972(1,2), when CO2 was first applied in the treatment of papilomatosis and early glottic malign lesions, its indications have risen, most especially in benign lesions, due to new technology developed over the last years as, for example, the reduction of microspot and the super-pulse, reducing the thermal effects on the tissues. METHODS: In this work, incisions with cold steel instruments and 1watt continuous mode and super-pulse CO2 laser were conducted on canine vocal folds. The amount of collagen deposited over the vocal folds was observed through histological exams using the Sirius Red method. RESULTS: The amount of collagen on the vocal folds was greater than the control group and statistically greater in the group of animals submitted to surgical procedures using cold instruments than procedures involving CO2. There was no statistical difference between the control group and the group submitted to incisions with cold steel instruments. CONCLUSIONS: The larynx surgery with CO2 laser, when employed in low potency, with small microspot and super-pulse, is a safe method in relation to the collagen deposit when compared with cold blade instruments.

larynx microsurgery; CO2 laser; collagen


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