• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.62-69
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• 1993

Recently, conservative and bloodless operative procedures have been focused, so that endoscopic laser have been used. However application of endoscopic laser surgery for laryngeal lesion is capable for followings: (1)capability of delivery through an operating microscope, (2) vaporization of ultraspot. $CO_2$ laser which has been used, has limitations for voice improvement because of 700 micron beam spot. KTP-532 laser which is capable of delivery through an operating microscope vapore 200 micron ultraspot has developed and applied to microlaryngeal surgery. We have experienced 60 cases who were contracted with hoarseness(53 cases of benign lesions vocal nodule 13, vocal polyp 13, bilateral diffuse polyposis of vocal cords 11, intracordal cyst 8, vocal papilloma 5, laryngocele 1, laryngeal stenosis 2 and 7 cases of malignant lesions : laryngeal carcinoma stage I and II) since 1991. We operated them with KTP-532 Laserscope(3 Watt/0.05 sec., pulsed or continuous. San Jose, Calif, USA). Forty eigh cases(90.6%) of 53 bengin laryngeal lesions and 4 cases(57.1%) of malignant lesions were significantly improved in their voices. There were a few complications and technical problems, but laser surgery alone had a limitation to eradicate the disease.

• 대한기관식도과학회지
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• 제5권2호
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• pp.153-158
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• 1999

Background and Objectives : The treatment of supraglottic stenosis remains a challenging problem in the field of otolaryngology due to its association with dyspnea, dysphagia, and frequent recurrence. Any satisfactory treatment is not yet known. The author experienced six cases of supraglottic stenosis and report the successful treatment of five cases by repeated endoscopic laryngeal excision with KTP-532 laser under suspension layngoscopy. Materials and Methods : Six adults who were treated for supraglottic stenosis between March 1994 and December 1998 at the Department of Otoloaryngology-Head and Neck Surgery, Korea University Medical Center were studied retrospectively. The patients were placed under general anesthesia followed by endoscopic laryngeal excision with KTP-532 laser under supension laryngoscopy. The scar tissue and granulation tissue were visualized with an operating microscope, and then removed using KTP-532 laser (15watts, continuous mode). Intraoperative local steroid(Triamcinolone ) was injected in all cases after the stenotic portions were removed. Results : Endoscopic excision was performed in five cases ; among the five cases, cricoid cartilage was concomitantly removed in two cases, and epiglottis was removed in one case. Satisfactory swallowing and airway respiration were possible in all five patients who underwent endoscopic widening. Conclusion : The treatment of supraglottic stenosis is different from that of tracheal or glottic stenosis in that supraglottic stenosis is mainly developed in membraneous form. Repeated laser excision and local steroid injection under suspension laryngoscopy is an effective and recommend able method for the treatment of supraglottic stenosis.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1995년도 이비인후과 종합학술대회 초록집
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• pp.91.2-91
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• 1995

레이저를 이용한 구강 및 인후두 수술시 endotracheal tubes의 손상은 치명적이라 아니 할 수 없다. 이에 저자들은 여러 가지 endotracheal tube를 실험 재료로 사용하여 보다 안전한 레이저 수술을 위해서 적절한 endotracheal tube를 찾기 위해 본 실험을 시행하였다. 실험에 사용된 tube는 총 5가지 - $Bivona^{TM}$, Xomed Laser Shield $II^{TM}$, Mallinckrodt Laser-$Flex^{TM}$, Rusch tube wrapped with aluminium foil tape(Rusch tube), Polyvinylchloride tube wrapped with aluminium foil tape(PVC tube) - 가 사용되었다. 사용된 레이저는 KTP/532 와 $CO_2$ laser 이며 모든 실험에서 tube를 $FiO_2$ 95%-98% 상태에서 조사하여 각각 5회씩 실시하였다. tube에 이상이 없거나 발화가 되지 않는 한 90초 동안 시행하였다. 실험 결과, KTP/532 조사시 $Bivona^{TM}$, Mallinckrodt 와 PVC tube는 심한 손상을 받거나 발화하였으며 Xomed 와 Rusch tube는 안정된 상태를 유지하였고 $CO_2$ Laser 조사시는 KTP/532 조사시와 유사한 결과를 얻었다. 한편 혈액을 endotracheal tube에 도포한 상황에서는 모든 tube가 더 심한 손상을 보이는 바 KTP/532 조사시 Xomed는 상당히 안정된 상태를 유지하였고 나머지 tube는 심한 손상 또는 발화를 보이고 $CO_2$ Laser 조사시 $Bivona^{TM}$ 와 Mallinckrodt는 발화하였고 Rusch tube는 표면이 녹았으며 Xomed와 PVC tube도 1례에서 발화하였다. 향후 이비인후과 영역에서의 레이저 수술이 증가함을 예상할 때 좀 더 레이저에 대하여 안정적이고 경제적인 endotracheal tube의 개발이 필요할 것으로 사료된다.

• 대한미세수술학회:학술대회논문집
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• 대한미세수술학회 1992년도 제12차 학술대회
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• pp.73-73
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• 1992

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.131-134
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• 2017

Sulcus vocalis remains a surgical challenge despite many recent advances in laryngomicrosurgeries. We previously reported that 585-nm Pulsed dye laser (PDL) exerts favorable outcome in treatment of sulcus vocalis due to its therapeutic effects of collagen rearrangement and improved wound remodeling. In spite of the usefulness of PDL glottoplasty for treating sulcus vocalis, the device is no more available in the country. It prompted us to focus another angiolytic laser ; 532-nm KTP laser which has similar mechanisms of action and has been used for treatment of other laryngeal lesions elsewhere. Herein, we present a case of sulcus vocalis successfully treated with KTP laser. A patient underwent laryngomicrosurgery with angiolytic KTP laser (KTP glottoplasty) by the same surgical procedure with PDL glottoplasty. After the surgery, the patient presented improved voice outcome in time without complications.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.92-95
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• 2020

Tracheal granuloma, the most commonly reported sequela of pediatric tracheotomy. A variety of techniques are available for the management of tracheal granuloma. Potassium-titanyl-phosphate (KTP) laser has been previously established as an acceptable technique for removal of laryngeal surgery, which emits a green light with a wave length of 532 nm, which is well-absorbed by hemoglobin and can coagulate and vaporize tissue. The ability to deliver laser energy through a flexible glass fiber makes the technique convenient for use with a rigid bronchoscope, overcoming problems with intraluminal access encountered with earlier attempts at CO2 laser therapy for this problem. Another advantage of KTP laser is the avoidance of the risks and morbidity associated with an open procedure. We report our surgical technique KTP laser in the management of tracheal granuloma removal into the tracheostomy site. KTP laser is good tool for management of tracheal granuloma with low incidence of complications.

• 대한후두음성언어의학회지
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• 제32권3호
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• pp.118-123
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• 2021

The pulsed photoangiolytic 532-nm potassium-titanyl-phosphate (KTP) laser has emerged in recent years as an efficacious treatment modality for vocal fold lesions. It also has broadened the indications for other laryngeal laser surgery. Features of KTP laser that it is a fiber-based delivery system and its energy is selectively absorbed by oxyhemoglobin make it suitable for office-based laryngeal procedures. An office-based KTP laser surgery provides an alternative management option for benign laryngeal diseases and can be performed comfortably under flexible endoscopic guidance which is placed through the nose of a fully awake patient. Office-based laryngeal surgery with a KTP laser can alleviate the need for general anesthesia. However, there are some limitations to apply due to reduced visual precision and the fact that the vocal folds are moving during procedures. Clinicians should carefully weigh the advantages and disadvantages of office-based procedures before a treatment option is selected. Patient selection and standardized laser energy parameters may help in decreasing complications and improving the treatment results.

• 한국광학회지
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• 제13권2호
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• pp.140-145
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• 2002

선폭 0.2nm인 파장가변 티타늄 사파이어 레이저를 펌핑 레이저로 사용하여 펌핑 레이저의 5편광(E┴$\pi$)과 P-편광(E∥$\pi$) 그리고 파장 변화 등에 따라 두께 1 mm인 Nd:YVO$_4$결정의 흡수율 및 연속 발진 Nd:YVO$_4$/KTP 레이저의 출력 특성을 측정하였다. 그 결과 S-편광 및 P-편광 펌핑 레이저의 파장에 따른 Nd:YVO$_4$결정의 최대 흡수율은 각각 809.4 nm일 때 82% 및 808.8 nm일 때 98%로 측정되었으며, 기본파인 Nd:YVO$_4$레이저(1064 nm) 출력의 기울기 효율은 각각 43% 및 52%로 측정되어 1000 mW 출력의 P-편광 펌핑 레이저에 대하여 최대 516 mW의 Nd:YVO$_4$레이저 출력을 얻을 수 있었다. 또한 P-편광 펌핑 레이저에 대한 내부공진기 진동수 배가된 제2고조파 Nd:YVO$_4$/KTP 녹색 레이저(532 nm)출력 기울기 효율은 23%로 측정되었으며 1000 mW 펌핑 출력에 대하여 빔질 파라메터 M$^2$=1.42인 최대 205 mW의 출력을 얻을 수 있었다.

• 대한후두음성언어의학회지
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• 제30권1호
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• pp.53-56
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• 2019

The optimal treatments of carcinoma in situ of glottis include radiotherapy, laser surgery and vertical partial laryngectomy. Conventional surgical treatments need general anesthesia and radiotherapy has several complications. Recently, the effectiveness of 532 nm potassium titanyl phosphate (KTP) laser has been proven and widely used in vocal fold diseases even some cases of vocal fold dysplasia. A patient with difficult laryngeal exposure underwent fiberoptic laryngeal laser surgery using KTP laser under local anesthesia, showed improved voice outcome and the glottic lesion was removed successfully without local recurrence and regional metastasis 18 months after surgery.

• 한국광학회지
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• 제14권3호
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• pp.292-297
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• 2003

최대 1.9 W의 레이저 다이오드 출력을 Nd:YV $O_4$결정 단면에 집속시키고 공진기 내부에 KTP 결정을 두어서 제2고조파 변환시켜 녹색광(532 nm) 레이저를 발생시켰다. 다이오드 레이저 스퍽트럼과 레이저 결정의 흡수 스펙트럼을 비교하여 최적의 다이오드 작동 온도를 찾았다. 공진기 길이와 출력경의 곡률을 변화시키면서 출력의 변화를 관측한 결과, 최대 80 ㎽의 녹색광 레이저 출력을 얻었으며 최대 출력을 내는 공진기 조건에서는 집속된 여기광의 직경과 TE $M_{00}$ 모드의 직경이 일치함을 알았다. 발생된 녹색광 레이저는 다중모드로 발진하였으며 출력 요동이 심하였다. 단일모드 발진을 시키기 위하여 브루스터 판과 에탈론 등을 사용하는 여러 가지 형태의 공진기를 시도하여 보았다. 실험 결과, 에탈론을 사용한 공진기에서 가장 큰 출력인 60 ㎽ 의 단일 종모드 출력을 얻었다. 단일모드로 발진하는 레이저의 출력 요동은 다중 모드에 비하여 1/10이하로 감소하였다.