[The application of KTP laser in otolaryngology - 3 years experience]. / Zastosowanie lasera KTP w otolaryngologii - 3 lata doswiadczen

INTRODUCTION: The KTP laser is popularly called the green laser is a type of Nd: YAG laser zawdzieczajacy its name from the additional element of KTP crystal which is a wavelength of 532 nm. AIM: The aim of this paper is to present our 3-year experience in the application of KTP laser in otolaryngology. MATERIAL: In the Department of Otolaryngology, CSK MON Military Medical Institute in Warsaw from 2008, performed 211 operations using the green laser. The study group was 89 women and 122 men aged 12 to 94 years (mean age 53.2 years). METHODS: The surgery was performed 15-watt KTP Aura laser. All guestrooms are fibers with a diameter of 0.2, 0.4 and 0.6 mm, and guides for inserting the fiber ends are not. Results: In 3-year period have made a 211 KTP laser surgery including the nasal cavity, mouth, larynx and trachea, and the outer ear. In the procedure adopted one day 76 people, and at least 111 patients stayed in hospital for 4 days. RESULTS: In our material patients after UPPP tonsillectomy and operations, in addition to a negligible bleeding during surgery, rarely also had late bleeding (5%). In our clinic konchoplastyki performed based on the so-called. technique of "cross-hatching". The laryngeal endoscopic surgery is used micromanipulator, if we are to remove a large tumor of the larynx much better to use the guide laryngeal. CONCLUSIONS: The KTP laser is an important tool in the operational procedures in otolaryngology in large part due to the high activity and its complexity hemostatycznemu assistant. Become familiar with the operation of the laser and improvement of surgical techniques allows patients to propose a modern surgical procedures. Improves the possibility of radical treatment of tumors of the larynx endoscopic method.

[Estimation of quality of voice after removal of neoplasms T1 and T2 of glottis with simultaneous reconstruction of vocal fold with pedunculated sterno-thyroid muscle flap]. / Ocena jakosci glosu po usunieciu nowotworów T1 i T2 glosni z jednoczesna rekonstrukcja faldu glosowego uszypulowanym platem z miesnia mostkowo-tarczowego.

INTRODUCTION: In recent years there has been an increasing number of cases of cancer, including cancer of the larynx. The choice of treatment should be primarily dictated by the complete elimination of cancer, but from the point of view of the patient, an important factor to keep in mind, is the quality of the voice that will be created at the end of the therapeutic process. AIM: The aim of this study was to evaluate the voice quality of patients after partial surgery of the larynx with vocal fold reconstruction pedunculated sterno-thyroid muscle flap. MATERIALS AND METHODS: The study included 30 men aged 53-72 years who were treated at the Clinic of Otorhinolaryngology Department of Medical-Dental Medical University of Warsaw on account of cancer of the larynx, qualified according to the TNM classification T1 or T2. The radical removal of cancer was associated with resection of one vocal fold, laryngeal pouches and ventricular fold. In 15 patients, included to the group I at the end of phase oncology surgery, a reconstruction of "vocal fold" pedunculated sterno-thyroid muscle flap were performed simultaneously. The group II consisted of 15 patients who underwent surgery that removed only the cancerous lesions. Impact assessments arising after surgery of voice disorders on quality of life were made using the self-test failure of the voice (Voice Handicap Index in the Pruszewicz modification). The nature of the created voice was studied using GRBAS scale. All patients performed the laryngostroboscope examination. With "IRIS" program, prepared by a team at Wroclaw University of Technology, the voice was recorded, and then was subjected to acoustic analysis. In addition, noise level and the maximum phonation time was measured. RESULTS: The results indicate that the patients of group I gained a better voice confirming the values of objective acoustic analysis. The assessment made by the scale GRBAS patients who supplemented the resulting loss after tumour removal, with much less hoarseness of voice, did not have the hyperkinesis and there was no puff character. They had the better flow of voice and phonation time of vowels "a" was much longer. The assessment of quality of life of patients in group I made in a test of the VHI was higher than in group II. The laryngostroboscope examination confirmed a good phonatory occlusion and a nearly regular, healthy vocal fold vibration in patients who had received flap of muscle. CONCLUSIONS: Evaluation of the quality of voice after removing the tumor multiplicity in the glottis with simultaneous reconstruction "vocal fold" has confirmed that this is a very good surgical technique, which allows radically curing cancer for the simultaneous preservation of a good voice. The operation has limited indications for radiotherapy because of the desire to preserve the phonatory function of the larynx, and thus avoids the negative effects of radiation.