Intraductal Lithotripsy in Sialolithiasis Using the Calculase III™ Ho:YAG Laser: First Experiences.


Journal

Lasers in surgery and medicine
ISSN: 1096-9101
Titre abrégé: Lasers Surg Med
Pays: United States
ID NLM: 8007168

Informations de publication

Date de publication:
04 2021
Historique:
revised: 24 08 2020
received: 02 07 2020
accepted: 13 09 2020
pubmed: 1 10 2020
medline: 29 10 2021
entrez: 30 9 2020
Statut: ppublish

Résumé

To report the first experiences with a newly available Ho:YAG laser system for the treatment of salivary stones. A retrospective study in a tertiary referral center was conducted. Patients diagnosed with sialolithiasis were treated in Erlangen using the Calculase III™ Ho:YAG laser (Karl Storz, Tuttlingen, Germany). Preset parameters had a frequency of 4 Hz and energy of 0.8-1.2 J, resulting in 3.2-4.8 W. Following total fragmentation, one to two serial sialendoscopies were performed to achieve complete fragment clearance. A total of 55 stones in 49 patients were treated; 17 stones in 15 submandibular glands and 38 in 34 parotids. In total, 61 laser lithotripsies (range 1-3 per stone) were performed using various modes (long, short, and burst) and with preset parameters of 4 Hz and energy of 0.8-1.2 J, resulting in effective power of 3.2-4.8 W. Complete fragmentation was achieved in all the accessible stones. Sialendoscopes, fibers, or the mode used had no significant influence on success rates. A multimodal therapy concept was employed to treat stones in 12.24% of the cases; 95.92% of the patients were ultimately stone-free, and all became symptom-free. All glands were preserved. The new Calculase III™ Ho:YAG laser was effective in the treatment of sialolithiasis with no increased risk of complications in the patients or damage to the sialendoscopes. Clinical factors such as the type of gland involved, or the location and size of stones had a greater impact on success rates than the technical or preset parameters. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Sections du résumé

BACKGROUND AND OBJECTIVES
To report the first experiences with a newly available Ho:YAG laser system for the treatment of salivary stones.
STUDY DESIGN/MATERIALS AND METHODS
A retrospective study in a tertiary referral center was conducted. Patients diagnosed with sialolithiasis were treated in Erlangen using the Calculase III™ Ho:YAG laser (Karl Storz, Tuttlingen, Germany). Preset parameters had a frequency of 4 Hz and energy of 0.8-1.2 J, resulting in 3.2-4.8 W. Following total fragmentation, one to two serial sialendoscopies were performed to achieve complete fragment clearance.
RESULTS
A total of 55 stones in 49 patients were treated; 17 stones in 15 submandibular glands and 38 in 34 parotids. In total, 61 laser lithotripsies (range 1-3 per stone) were performed using various modes (long, short, and burst) and with preset parameters of 4 Hz and energy of 0.8-1.2 J, resulting in effective power of 3.2-4.8 W. Complete fragmentation was achieved in all the accessible stones. Sialendoscopes, fibers, or the mode used had no significant influence on success rates. A multimodal therapy concept was employed to treat stones in 12.24% of the cases; 95.92% of the patients were ultimately stone-free, and all became symptom-free. All glands were preserved.
CONCLUSIONS
The new Calculase III™ Ho:YAG laser was effective in the treatment of sialolithiasis with no increased risk of complications in the patients or damage to the sialendoscopes. Clinical factors such as the type of gland involved, or the location and size of stones had a greater impact on success rates than the technical or preset parameters. Lasers Surg. Med. © 2020 Wiley Periodicals LLC.

Identifiants

pubmed: 32997838
doi: 10.1002/lsm.23325
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

488-498

Informations de copyright

© 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC.

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Auteurs

Michael Koch (M)

Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.

Mirco Schapher (M)

Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.

Konstantinos Mantsopoulos (K)

Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.

Heinrich Iro (H)

Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.

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