A new 532 nm, variable-pulse-structure, dual-wavelength, KTP laser incorporating cryogen spray cooling, effectively treats rosacea.

BACKGROUND: A new dual-wavelength, high-energy, solid-state laser incorporating both 532 and 1064 nm wavelengths was developed with cryogen spray cooling and the unique ability to deliver three types of pulse structures including single pulses of a specific pulse-duration or pulses composed of a train of subpulses in the millisecond or microsecond domain with an intervening delay over the selected pulse-duration. We investigate the efficacy of this laser using all three pulse structures and the 532 nm wavelength for treating rosacea. METHODS: Twenty-one subjects were enrolled in this IRB-approved study. A total of up to three treatments were administered at monthly intervals. Each treatment consisted of a first pass tracing linear vessels with a 40 ms pulse-duration immediately followed by a second pass using a 5 ms pulse, using all three available pulse structures. Assessment of cross-polarized digital images by blinded physician observers compared baseline and 3-month follow-up images. RESULTS: Blinded observers correctly identified the posttreatment images 89% of the time, in 17 of 19 subjects completing the study, with an average overall improvement rating of 39% after only three treatments. Side effects were limited to short-term erythema and edema. CONCLUSION: This study demonstrates that this new, variable-pulse-structure, dual wavelength, solid state, KTP laser with dynamic cooling is a safe and effective for treating rosacea.

In-office KTP laser treatment for laryngeal pathologies: 5-years outcomes.

INTRODUCTION: In the past two decades, laser systems were introduced into the office setting for laryngeal pathologies, offering the advantages of a shorter procedure and recovery. To date, long-term data on outcomes is limited. This study aims to evaluate the efficacy and safety of the office-based potassium-titanyl-phosphate (KTP) laser procedure for laryngeal pathologies. METHODS: A retrospective cohort of in-office KTP laser procedures for two main vocal folds lesions groups: (i) benign and pre-malignant; and (ii) intraepithelial lesions in a prior invasive cancer field between 2010 and 2020. Data were collected from electronic medical records, telephone interviews, and video documentation of the procedure, including treatment completion, disease control, and whether additional interventions were required. RESULTS: A total of 81 patients underwent 153 in-office KTP laser procedures for benign (36, 44.4%), pre-malignant (15, 18.5%), and lesions in a prior malignancy field (30, 37.1%) with a mean of 1.89 ± 1.81 procedures per patient. One hundred and thirty-eight (90.2%) procedures were well tolerated and completed successfully. During the 5-years of follow-up, 63% of the patients with previous malignancy were managed exclusively in the office. In the pre-malignant group, 76% required no additional type of intervention. Patients with papilloma required significantly more procedures per patient compared with other pathologies (3.6 ± 4 vs. 1.61 ± 1, p-value = 0.02). Surgery was required only in 18.2% of the papilloma patients. Three (1.9%) patients had short-term complications, all resolved within 6 months. Failure to complete the procedure was significantly associated with active smoking (p-value < 0.001) and, in most cases (90%), was related to patient intolerance. CONCLUSION: Office-based KTP laser laryngeal procedures have shown promising results for both benign and selected cases of lesions in a prior malignancy field with a high compliance and a very low complication rate, suggesting its use as an effective and safe treatment modality for selected patients.

Laser therapy as a treatment for chronic radiation fibrosis.

BACKGROUND: Chronic radiation fibrosis (CRF) is a long-term sequala of radiation therapy that has a significant impact on patient quality of life. There is no standard of care or single therapeutic modality that has been found to be consistently effective. OBJECTIVE: To describe our experience using fractional 10,600 nm carbon dioxide (CO2 ) laser therapy and vascular laser therapy in a series of patients with CRF. METHODS: Patients presenting to the dermatology service for CRF were evaluated for laser therapy eligibility. Patients were eligible if they had a clinical diagnosis of CRF confirmed by physical examination. RESULTS: We identified five patients with CRF treated with fractional ablative CO2 laser and vascular laser. Patients were a median age of 57 years old, and the amount of time between the initiation of radiotherapy and laser treatment ranged between 3 months and 40 years. The satisfactory response was achieved in all cases. LIMITATIONS: Lack of standardized laser protocol, small sample size, lack of a control group, different anatomical locations CONCLUSION: Fractional ablative and vascular laser therapy may serve as an additional treatment for CRF, leading to functional improvements.

Assessment of the Effectiveness of Treatment of Vascular Lesions within the Facial Skin with a Laser with a Wavelength of 532 nm Based on Photographic Diagnostics with the Use of Polarized Light.

Aesthetic medicine is a dynamically developing field of medicine. It has an impact not only on the improvement of the external appearance, but also on health and quality of life. Currently, vascular changes affect many patients and significantly diminish the condition of the skin. The development of modern laser therapy has contributed to the successful management of multiple skin conditions, among them vascular lesions. The aim of our study was to show the efficacy of repetitive 532 nm laser therapy in reducing vascular skin lesions located on the facial area. Observations were possible due to the implementation of System of Skin Analysis. We retrospectively analyzed the records of 120 patients (100 women and 20 men) using "VISIA" Skin Analysis System after 532 nm laser therapy. Treatment with the use of the 532 nm vascular laser turned out to be effective in reducing vascular changes in both women and men. The skin phototypes did not significantly affect the therapy efficacy. Neither the age of patients nor number of laser sessions affect therapy efficacy. 532 nm laser therapy is effective in reducing vascular skin lesions located in the face area.

Evaluation of postoperative pain relief after pulpotomy using different procedures for disinfection and hemostasis in symptomatic irreversible pulpitis.

Aim: This study aimed to evaluate postoperative pain scores after sodium hypochlorite (NaOCl) and KTP laser pulpotomies in the permanent teeth with symptomatic irreversible pulpitis retrospectively. Materials and Methods: This study is based on the records of patients treated with pulpotomy using sodium hypochlorite or KTP laser for disinfection and hemostasis at the Department of Endodontics. Sixty patients' molar teeth were treated with either NaOCl or KTP laser. Sodium hypochlorite was used on 31 teeth, and KTP laser was used on another 29 teeth, for disinfection and hemostasis. Initial bleeding control was obtained with saline. 2.5% NaOCl or KTP laser was applied to complete hemostasis. Calcium hydroxide was then placed on the chamber floor to cover the canal orifices. The permanent restoration was completed with composite resin. Pre and postoperative pain scores were recorded with a visual analog scale. The evaluation was performed on the 6th, 24th, 48th, 72nd hours, and 7th days depending on the severity of the pain. Results: There was no significant difference between the groups in terms of demographic data and preoperative pain scores (P > 0.05). The postoperative pain score in the KTP laser group was significantly lower at the 24th hour than in the NaOCl group (P < 0.05). No significant difference was found between the groups at other evaluated time intervals (P > 0.05). The greatest pain score was recorded at the 6th hour in both groups. Conclusion: Although the level of pain decreased significantly in both groups in the postoperative period, KTP laser-assisted pulpotomy provided better pain control, especially at the 24th hour.

Effects of laser modalities on shear bond strengths of composite superstructure to zirconia and PEEK infrastructures: an in vitro study.

In the last decade, demand for metal-free esthetic restorations has grown considerably due to the development of materials to fulfill the need for an esthetic prosthesis. We examined the effects of erbium-doped yttrium aluminum garnet (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), and potassium titanyl phosphate (KTP) laser applications on the shear bond strength (SBS) of nanohybrid composite superstructures to zirconia and PEEK infrastructures. Zirconia and PEEK specimens were prepared with CAD/CAM technology in accordance with ISO 11405 standards. The disc-shaped samples were randomly separated into four groups (n = 8) according to applied laser type: no treatment and Er:YAG, Nd:YAG, and KTP lasers. Nanohybrid composite resin was applied as a veneering material to each infrastructure. After surface treatment of infrastructures by the lasers, the SBS test was carried out to determine the bonding of infrastructures, which were also examined with a stereomicroscope. The SBS were significantly higher in the PEEK specimens treated with the studied lasers. Nd:YAG laser was the most effective method, followed by Er:YAG laser and KTP laser. The lowest SBS value was obtained in the no-treatment group. Stereomicroscopically, the studied lasers produced different irregularities on the infrastructures. PEEK as a framework provides meaningfully higher bonding strength to composite resins compared to zirconia. Nd:YAG, Er:YAG, and KTP, in descending order, are efficacious in increasing the attachment of studied structures.

New technology for coagulation of dilated vessels using the combined effects of several modes of generation and wavelengths in one laser pulse for the treatment of pediatric hemangiomas: Open prospective study.

An open, prospective, nonrandomized study of 122 children with infantile hemangiomas aged 1 to 24 months was conducted to evaluate the effectiveness and safety of treatment with multiline laser equipment using the Nd:YAP Q-Sw/KTP emitters with the combined use of two wavelengths of 1079/540 nm. The average age of the children was (6.3 ± 0.3) months, 22 of them were boys (18.0%) and 100 were girls (82.0%). An erythometry and ultrasound examination were performed to determine the depth of the neoplasm, to assess its blood flow, and the presence and diameter of the supply vessels. Studies of these indicators were conducted for patients before and after the treatment. Laser treatment was performed on 109 patients with 119 hemangiomas. A total of 81 superficial hemangiomas underwent a short course of laser therapy (2-5 procedures) and remaining patients with 38 combined hemangiomas received a long course of laser treatment, consisting of 6 to 10 procedures. Restoration of normal color, skin relief, and the absence of scars were noted in post-treatment sample on evaluation. After the course of treatment, erythometry readings corresponded to the values of normal skin and decreased to 110 to 80 cu. Ultrasound examination showed vascular formation and feed vessels were not visualized.

Comparison of efficacy of potassium titanyl phosphate laser & diode laser in the management of inferior turbinate hypertrophy: A randomized controlled trial.

Background & objectives: Inferior turbinate hypertrophy (ITH) is a common condition causing nasal obstruction. This study was undertaken to compare the efficacy of potassium titanyl phosphate (KTP) laser and diode laser in the reduction of the turbinate size. Methods: This randomized controlled trial included 209 patients with ITH. Pre-operative symptoms were assessed based on the Nasal Obstruction Symptom Evaluation (NOSE) score. Diagnostic nasal endoscopy was done to rule out other nasal sinuses. Nasal mucociliary clearance was measured by saccharin transit time (STT). Postoperatively, the NOSE score, STT and complications were assessed at days one and two, at one week, one month and three months. Results: Of the 209 patients analyzed at day one, the median NOSE score was 50 in the diode group and 40 in the KTP group, and at three months, 15 in the diode group and five in the KTP group. KTP laser showed a 93 per cent improvement in the NOSE score as compared to 77 per cent improvement shown by diode laser group. Among the intra-operative complications, of the 104 patients in the diode group, 6.73 per cent had burning sensation and 91.43 per cent had bleeding, and of 105 patients in the KTP group, 54.29 per cent had burning sensation and 36.54 per cent had bleeding. Among the post-operative complications in the KTP group, 32 and 34 per cent had bloody nasal discharge on days one and two, compared to 12 and 14 per cent in diode group. Crusting was present in 61 and 49 per cent on days one and two in KTP group as compared to 9 and 15 per cent in diode group, respectively. In the KTP group 30 per cent had synechiae as compared to 10 per cent in diode group. Interpretation & conclusions: KTP laser was more efficacious than diode laser in improving the NOSE scores but with slightly increased rate of complications in early post-operative period. Both the lasers impaired the mucociliary clearance mechanism of the nose till three months of post-operative follow up.

CO2 Laser Cordectomy Versus KTP Laser Tumor Ablation for Early Glottic Cancer: A Randomized Controlled Trial.

BACKGROUND AND OBJECTIVES: CO2 laser cordectomy has been the workhorse of laser surgery for early glottic squamous cell carcinoma (GSCC) since the early 1970s. During the last decades, potassium titanyl phosphate (KTP) laser surgery for early GSCC gained popularity, introducing the tumor ablation technique. Yet, there are no previous randomized controlled trials (RCT) that compare the oncologic and functional outcomes of KTP Laser ablation versus CO2 laser cordectomy for early GSCC. This study aims to compare by means of an RCT, CO2 laser cordectomy with KTP laser ablation for early GSCC, in terms of cure rates and vocal function. STUDY DESIGN/MATERIALS AND METHODS: A RCT conducted between 2013 and 2017. Patients with early GSCC were enrolled, and randomly assigned for either CO2 cordectomy or KTP-ablation surgery with curative intent. All CO2 cordectomies and most KTP-ablation procedures were performed under general anesthesia. Some KTP cases with residual disease were treated also under local anesthesia. Videostroboscopy measures, voice handicap index (VHI), GRBAS (a hoarseness scale for Grade, Roughness, Breathiness, Asthenia and Strain) score, and acoustic analyses were performed pre-operatively, 6 months and 3 years after surgery. RESULTS: Twenty-four patients, 12 in each group, were enrolled. Nine in each group had T1a carcinoma, the remaining had either carcinoma in situ or T1b. The average number of procedures was 1.67( ± 0.89) and 1.33( ± 0.89) for the KTP and CO2 groups, respectively. Although the tumor depth was comparable in both groups, patients in the KTP-ablation group underwent more superficial surgeries. Eleven (91.7%) procedures in the KTP group spared the vocal ligament, compared with 5 (41.7%) in the CO2 group, (P = 0.023). All patients were alive and disease-free after four years. On post-operative videostroboscopy, normal mucosal waves appeared in 5 (42%) of the KTP patients versus none (0%) of the CO2 (P = 0.02). The median post-operative non-vibrating portion was smaller in the KTP group (10%) compared with CO2 (50%), P = 0.043. Nevertheless, GRBAS and VHI scores improved comparably in both groups. CONCLUSIONS: KTP ablation technique offers similar curative outcome as CO2 cordectomy but may allow for better preservation of vocal fold's architecture and function. Yet, the clinical significance of these findings is unclear, since the subjective measures improved comparably for these two treatment modalities. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.

Effect of different laser types on bonding strength of CAD/CAM-customized zirconia post to root canal dentin: an experimental study.

In clinical dentistry, the strength of bonding zirconia posts to root canal dentinal walls currently needs enhancement, and laser application can be an important contribution owing to its features that accommodate adjustable modifications on dental materials. Herein, the effect of different laser treatments applied to dentin surfaces on the strength of bonding zirconia posts to root canal dentinal walls is evaluated by using the pull-out bond strength test in a laboratory setting. A total of 40 single-rooted permanent mandibular premolar teeth that were freshly extracted were used here. The root canal preparation steps were performed using the crown-down technique. Custom-made zirconia posts were produced using CAD/CAM technology. Prior to the application of resin cement, the internal surfaces of the root canals were irradiated using Nd:YAG, Er:YAG, and KTP lasers. Pull-out tests were performed on each specimen by using a universal testing machine. One-way analysis of variance and Tukey post hoc tests were used to compare the pull-out bond strength data. The bond strengths of the laser-treated specimens were greater than those of the untreated controls (p < 0.05). While the value of the pull-out bond strength after Nd:YAG laser treatment was significantly higher than the values obtained after the applications of the Er:YAG and KTP lasers (p < 0.05), the pull-out bond strength after Er:YAG laser treatment was considerably greater than that after KTP laser treatment (p < 0.05). The bond strength between the root canal dentin and the CAD/CAM custom-made zirconia post was improved upon using all the laser modalities in current laboratory settings, among which, application of the Nd:YAG laser was the most successful.

Treatment of telangiectasia on the cheeks with a compact yellow (585 nm) semiconductor laser and a green (532 nm) KTP laser: a randomized double-blinded split-face trial.

OBJECTIVES: The primary objective of this study was to compare a traditional green KTP laser to a new investigational yellow laser (PhotoLase) in the treatment of facial telangiectasia in terms of the treatment outcomes. The secondary objective was to assess the functionality and reliability of the PhotoLase system from the perspective of the user. STUDY DESIGN/METHODS: The study was a randomized split-face double-blinded study that compared the treatment efficacy of the 532-nm KTP laser and the investigational 585-nm PhotoLase laser. One or two treatments were given based on the response of the first treatment. The improvement of telangiectasia was graded according to a 7-point Telangiectasia Grading Scale (TGS) by the subjects and blinded physicians. The subjects assessed the amount of pain during the treatments using Visual Analogue Scale (VAS), and evaluated adverse effects 2-3 days after the treatment(s) using a self-assessment form. RESULTS: At least 50% improvement was seen in 15/18 subjects after the first PhotoLase treatment, and a similar result was observed for KTP, as assessed by the blinded physicians (P = 0.29). In the subjects' assessment, 7/18 subjects had at least 50% improvement after the first PhotoLase treatment, whereas at least 50% improvement was observed for 10/18 subjects in the KTP side, the difference being significant (P = 0.008). The amount of pain was higher with PhotoLase compared to KTP (67.7 vs. 34.6, P < 0.001). There was no difference in the frequency of erythema, crusting or purpura between the devices, but more blistering and less edema were seen after PhotoLase treatment (P < 0.05). Treatment with PhotoLase was evaluated to be 4.7-fold faster than with KTP and the PhotoLase system was more compact, narrower, lighter, and easier to carry than KTP. CONCLUSIONS: The investigational PhotoLase laser enables significantly faster treatments, but the process is somewhat more painful than with KTP, otherwise providing a similar clinical outcome in the treatment of facial telangiectasia. Treatment Protocol Lasers Surg. Med. 51:223-229, 2019. © Wiley Periodicals, Inc.

Prospective study of removing solar lentigines in Asians using a novel dual-wavelength and dual-pulse width picosecond laser.

OBJECTIVES: Quality-switched (QS) lasers are known to be an effective treatment for removing solar lentigines, however, high incidence of post-inflammatory hyperpigmentation (PIH) is a concern in darker skin types. The objective of this study was to evaluate the efficacy and safety of a dual-wavelength and dual-pulse width picosecond Nd:YAG laser for removing solar lentigines in Asians. METHODS: This was a prospective, IRB-approved study. Twenty cases with solar lentigines on the face were enrolled for treatment and evaluated at 1- and 3-month after the final treatment. Results were assessed by blinded evaluators using a 5-grade percentage improvement scale and Melanin index (MI) measured by a reflectance spectrophotometer. A patient self-assessment questionnaire was also administered using a 5-grade improvement scale. Additional treatment was performed if the improvement was less than 75% or the lentigo partially remained after 4 weeks. Histological evaluation was performed to compare the differences between the current picosecond laser and a QS Nd:YAG laser 532-nm using light and electron microscopy. RESULTS: Forty-three lesions in 20 females, skin type III or IV, age 53.7 ± 9.75 were treated and evaluated. The laser setting was: 532-nm, 750 picoseconds, average fluence of 0.35 ± 0.06 J/cm [2] using a spot size of 3 or 4 mm. Forty lesions (93.02%) achieved over 75% clearance with a single treatment and the other three lesions (6.98%) needed two treatments. PIH occurred only in 4.65% of lesions. The average score of the blinded evaluators' assessment was 4.77 and 4.58 on a 5-grade percentage improvement scale. The patients' self-assessment rating was 4.76 and 4.67 on a 5-grade scale at 1- and 3-month follow-up, respectively. The improvement rate of relative MI (MI in the lesion minus that of the normal area) was 77.60 ± 36.27% and 76.93 ± 20.95% at 1-and 3-month follow-up. Histology showed vacuolar formation by both lasers in the epidermis that were different sizes between lasers. Electron microscopy showed destruction of melanosomes with surrounding tissue damage with the QS laser and without particular damage with the picosecond laser. CONCLUSIONS: To the best of our knowledge, this is the first study using a picosecond Nd:YAG laser 532-nm for removing solar lentigines in darker skin types that includes histological evaluation. Although there are many options to treat solar lentigines, our results suggest that picosecond laser with preferable endpoint determination can be a safer and more effective treatment over conventional treatments in Asian patients. Lasers Surg. Med. 50:851-858, 2018. © 2018 Wiley Periodicals, Inc.

The effect of the KTP laser on smear layer and temperature change: an in vitro study.

The purpose of this study was to evaluate the effects of potassium-titanyl-phosphate (KTP) laser irradiation on smear layer removal and temperature changes of the root surfaces. Two hundred four extracted single-root human premolars were included. The canals were instrumented and divided into two main groups: group A (smear layer examination n:119) and group B (temperature change examination n:85). Each group was divided into subgroups (n:17) according to the different five laser power settings: A1, B1: 1 W-5.33 J/cm2; A2, B2: 1.5 W-7.52 J/cm2; A3, B3: 2 W-10.3 J/cm2; A4, B4: 3 W-15.5 J/cm2, A5, B5: 4 W-20.1 J/cm2, A6: positive control no laser irradiation-irrigated 2 mL for 2 min 2.5% NaOCl + 2 mL distilled water and A7: negative control groups no laser irradiation irrigated 2 mL for 2 min 17% EDTA + 2 mL for 2 min 2.5% NaOCl + 2 mL distilled water. The temperature elevations were measured with an infrared thermographic camera and smear layer examined by scanning electron microscope. According to Kruskal-Wallis and Tukey's tests, in all groups the highest smear scores were in the apical third. In all areas, there were statistically significant differences between negative control group (17% EDTA) and all other groups (p < 0.05). The highest smear scores were determined in 1 W KTP laser and positive control (2.5% NaOCl) groups. Statistically, in all thirds, the differences the 3 W and 4 W KTP laser groups between each other and all other groups were significant (p < 0.05). After the end of the use of the laser, increase in temperature values in all groups were found to be below 10 °C in 20 s.

[Laser in laparoscopic urology].

Nowadays, various laparoscopic instruments for tissue dissection and vessel coagulation are available. However, there are ongoing studies dedicated to "ideal" type of energy suitable for this aim. Laser radiation has been used for many years in medical practice and it is established as reliable and effective method in surgical armamentarium. The ability to provide highly precision and well-controlled action on the tissues, improved hemostasis, easy adaptability to fiber-optic and minimally invasive delivery systems, as well as the possibility of facilitating complex dissection made lasers an important tool for surgeons. The mechanism and methods of laser energy using in urology have been studied since 1980s, but there is still no consensus on the optimal type of laser and its settings during urological surgeries, which determines the importance of further researches dedicated to this promising form of energy.

A case report of combination treatment with potassium-titanyl phosphate laser and brimonidine topical gel in erythematotelangiectatic rosacea.

Laser therapies have been shown to provide symptom improvement in patients with erythema and telangiectasia of rosacea; however, they are associated with side effects such as erythema. Combinatorial treatment with pharmacological agents and laser have demonstrated better efficacy, fewer side effects and continued long-term remission compared with monotherapies. A case of moderate facial erythema that responded well to combination treatment with brimonidine 3 mg/g gel and a treatment course of potassium-titanyl phosphate (KTP) laser therapy is presented, showing a reduction from baseline, maintained after final laser session, by applying brimonidine 3 mg/g gel daily. Using brimonidine 3 mg/g gel to target post-laser treatment erythema is highly effective in minimising refractory erythema. Continued use of brimonidine 3 mg/g gel provides a sustained reduction of erythema, increasing the visibility of other signs and symptoms of rosacea that may be present. This can facilitate the treatment of these additional signs and symptoms.

Morphological and Histological Effects of Radiofrequency and Laser (KTP and Nd:YAG) Treatment of the Inferior Turbinates in Animals.

The aim of this study was to evaluate the short and medium-term effects of radiofrequency (RF) and potassium titanyl phosphate (KTP) and neodymium-yttrium-aluminum garnet (Nd:YAG) laser treatment on the inferior turbinate mucosa in a porcine model. Following randomization, the inferior turbinates were treated either with RF submucosally or with the KTP or the Nd:YAG laser on the surface under videoendoscopic control. Tissue samples were taken at the end of postoperative weeks 1 and 6, and were evaluated macroscopically and histopathologically. Scanning electron microscopy was implemented to demonstrate the morphological changes in the respiratory epithelium. Six weeks following the RF procedure, the mucosa was intact in all cases, and the volume of the inferior turbinates was reduced in the majority of the cases. Although a volume reduction occurred in both laser groups, more complications associated with the healing procedure were noted. With hematoxylin and eosin and periodic acid-Schiff staining, intact epithelium, and submucosal glands remained after the RF procedures at the end of postoperative week 6. Following the KTP-laser intervention, necrotizing sialometaplasia and cartilage destruction occurred, and squamous metaplasia was also apparent in the Nd:YAG group. In both laser groups, dilated glands with excess mucus were seen. The scanning electron microscopic findings demonstrated that cilia were present in all cases. In conclusion, the medium-term macroscopic results were similar in all 3 groups, but the postoperative complications were less following the RF procedure. RF procedure is minimally invasive due to the submucosal intervention that leads to a painless, function preserving recovery.

Prospective, randomized, evaluator-blinded study of the long pulse 532-nm KTP laser alone or in combination with the long pulse 1064-nm Nd: YAG laser on facial rejuvenation in Asian skin.

BACKGROUND AND OBJECTIVE: Hyperpigmentation is a common concern in Asian patients. Few published studies address overall skin rejuvenation in this group using long-pulse (LP) laser to target pigmentation and stimulate dermal remodeling. The LP KTP 532-nm laser (LP 532-nm) is used primarily to remove epidermal lesions, while the LP Nd: YAG 1064-nm laser (LP 1064-nm) is used to stimulate dermal remodeling in Asian patients with varying efficacy. The LP 532-nm used alone and in combination with LP 1064-nm to reduce pigmentation and rejuvenate skin was previously evaluated in lighter skin, but not in Asian skin. We evaluated the safety and effectiveness of using LP 532-nm for overall photorejuvenation, with and without LP 1064-nm. STUDY DESIGN/MATERIALS AND METHODS: Four treatments were administered at 3-week intervals to 22 Japanese females with photodamaged facial skin and bilateral solar lentigines. A direct split-face treatment with LP 532-nm was used on the full-face, and an additional, randomized LP 1064 treatment was administered to one-half of the face. Patients were not fully aware which side of the face was treated with which treatment. Results were evaluated at each treatment, and at 1- and 3-month follow-up visits. RESULTS: Scoring of a modified pigment severity index (mPSI) and measurement of the melanin index (MI) showed that facial skin treated with LP 532-nm alone and in combination with LP 1064-nm resulted in improvement at the 1- and 3-month follow-up (P < 0.001), but there was no difference between the two sides of the face. Notably, the three dimensional analysis of skin surface showed improvements for the dual-wavelength treatments with significant differences between the two sides (P = 0.003). Most patients reported moderate improvement and were extremely satisfied or satisfied with the outcome. Adverse events were minor and rare. CONCLUSIONS: Pigment-related skin rejuvenation using LP 532-nm appears to be safe and effective for Asian skin. The addition of LP 1064-nm showed no clinical difference but the subtle difference was detected by the 3D analyzing device. Lasers Surg. Med. 48:844-851, 2016. © 2016 Wiley Periodicals, Inc.

Single-center experience with potassium titanyl phosphate (KTP) laser for superficial cutaneous vascular lesions in face.

BACKGROUND AND OBJECTIVES: Superficial cutaneous vascular lesions (SCVLs) are quite common. Several types of lasers have been used to treat these lesions; however, there are no dedicated treatment guidelines and few studies in the literature addressed their treatment. AIMS: In this paper, we aimed to report our clinical experience with potassium titanyl phosphate (KTP) laser treatment on different types of facial SCVLs including telangiectasia, spider angioma, and erythema. METHODS: Data were retrospectively collected from 146 patients with SCVLs, who had been treated with the 532-nm wavelength laser at our outpatient dermatology clinic. Treatment responses were graded as four groups: clearance (> 75% improvement compared with the previous session), marked improvement (50-75%), partial improvement (25-50%), and no response (< 25%). RESULTS: The rate of clearance plus marked improvement (favorable outcome) was 66.1% for telangiectasia group, 93.5% for spider angioma group, and 26.7% for erythema group. Mean number of treatments was 2.9 ± 1.4 for telangiectasia group, 1.4 ± 0.8 for spider angioma group, and 2.9 ± 1.7 for facial erythema group. Only minimal adverse effects related to treatment procedure were detected in 5 out of 146 (3.4%) patients. CONCLUSIONS: Our results demonstrated that KTP laser might be a safe and effective laser modality for SCVLs, which may be associated with physiological problems due to cosmetic concerns.

Symptomatic vallecular cysts: diagnosis and management with the KTP laser.

UNLABELLED: The objective of this study is to discuss the evaluation and treatment of patients with vallecular cysts removed via potassium titanyl phosphate (KTP) laser therapy. This is a retrospective cohort study with longitundinal follow-up. Clinical records were reviewed for demographic information, symptoms, and findings on laryngoscopy of nine patients having had KTP laser surgery for vallecular cysts. Nine patients (six female, three male) had vallecular cysts removed via KTP laser. The average age at the time of removal was 61, with a range of 34-95 years. The most common preoperative symptom was dysphagia, present in two-thirds of patients. The most common physical exam finding was a smooth, rounded vallecular cyst with reproduction of symptoms upon palpation of the lesion. More than half of the patients had a history of laryngopharyngeal reflux disease and were being treated with acid-reducing medication. Only, patient #1 had a history of trauma. All but two patients had a vallecular cyst located on the right side. Four of the patients underwent treatment in the office procedure room and five in the operating room. The average age of those treated in the office was 71 and 53 in the operating room. 89 % of patients had complete resolution of symptoms post operatively. Patient #4, treated in the office, continued to experience the symptoms but was lost to follow-up. No complications or adverse events were noted. KTP laser removal of vallecular cysts is a successful treatment option for symptomatic patients. Furthermore, the ability to remove such lesions in an office setting is advantageous, cost-effective, and convenient. LEVEL OF EVIDENCE: Level 4.

Comparison of hearing results following the use of NiTiBOND versus Nitinol prostheses in stapes surgery: a retrospective controlled study reporting short-term postoperative results.

The aim of this retrospective study was to compare the 3-month postoperative hearing results following laser stapedotomy with the use of NiTiBOND versus Nitinol prostheses (31 and 39 patients, respectively). The operations were performed between September 2012 and September 2014, and between March 2006 and December 2012 regarding NiTiBOND and Nitinol, respectively. Twenty of the consecutive 31 patients were female and 11 were male for NiTiBOND, while 11 were male and 28 were female for Nitinol. The mean age was 43.8 years (range 22-61) and 46.9 years (range 28-83) for NiTiBOND and Nitinol, respectively. No significant cochlear trauma was documented postoperatively. The mean air-bone gap (ABG) for the frequencies 0.5, 1, 2 and 3 kHz at the 3-month postoperative follow-up was 7.6 dB (SD 4.7), and 9.3 dB (SD 4.1) for NiTiBOND and Nitinol, respectively. The differences between the mean pre- (p = 0.179), and postoperative (p = 0.059) ABG of the two groups were not significant. ABG closure within 10 dB was achieved in 77.4 and 59 % for NiTiBOND and Nitinol, respectively, the difference was not significant (p = 0.10). Two cases of delayed facial paralysis occurred, 1 with Nitinol and 1 with the NiTiBOND. All patients attained an ABG <20 dB following surgery. Laser stapedotomy with the application of either heat-memory piston prosthesis allowed an easy and minimally invasive approach with excellent short-term hearing results when the NiTiBOND prosthesis was applied. Laser application allowed manipulation in a bloodless environment and avoided manual crimping of the incus.