Effect of Pulse Modulation on Diode-Pumped Laser Lithotripsy.

This study addresses pulse modulation for kidney stone lithotripsy using diode-pumped thulium yttrium aluminum garnet (Tm:YAG, λ = 2.02 µm) and thulium fiber lasers (TFLs, λ = 1.94 µm).

Histology-Grounded Automated Plaque Subtype Segmentation in Intravascular Optical Coherence Tomography.

Background: Intravascular optical coherence tomography (IVOCT) adoption has been limited by the complexity of image interpretation. The interpretation of histologic subtypes beyond lipid, calcium, and fibrous is challenging to human readers. To assist and standardize IVOCT image analysis, we demonstrate an artificial intelligence algorithm based on a histology data set that identifies lipid pools, fibrofatty, calcified lipid, and calcified fibrous in human coronary arteries for the first time.

Feasibility and validation of a synthetic airway model for in situ laser dissection.

Background: This study measured the effectiveness of an in-house designed, cast silicone airway model in addressing the lack of easily accessible, validated transoral laser microsurgery simulation models.

Methods: Participants performed resection of two marked vocal fold lesions on the model. The model underwent face, content and construct validation assessment using a five-point Likert scale questionnaire measuring the mean resection time for each lesion and the completeness of lesion excision.

A multi-centre, participant-blinded, randomized, 3-year study to compare the efficacy of Virtual Surgical Planning (VSP) to Freehand Surgery (FHS) on bony union and quality of life outcomes for mandibular reconstruction with fibular and scapular free flaps: study protocol for a randomized phase II/III trial.

Background: Advanced head and neck malignancies with underlying bony involvement often require aggressive oncological resection of large segments of the oral cavity including the mandible. These patients require vascularized donor osseous free tissue transfer to reconstruct significant defects. Traditionally, the donor bone is harvested on its vascular supply and shaped to the defect in a free hand fashion (FHS).

Warm irrigation fluid effect on Thulium fiber laser (TFL) ablation of uroliths.

Prior laser studies have demonstrated that as the temperature of a medium increases, the amount of energy delivered to the target increases. We sought to investigate the role of irrigation fluid temperature on Thulium fiber laser (TFL) urolith ablation. 360 calculi were divided in vitro according to chemical composition: calcium oxalate monohydrate (COM), cystine (CYS), struvite (STR), calcium phosphate (CAP), uric acid (UA), and calcium oxalate dihydrate (COD).

Scapula or Fibula?: Prospective data-driven decision criteria for flap selection in mandibular reconstruction planning.

Objectives: The objectives of the study are twofold: 1) to propose a set of criteria for virtually evaluating different types of reconstructions for mandibular defects during surgical planning, and 2) to prospectively apply the criteria to a series of mandibular reconstructions to select the optimal flap.

Materials And Methods: Clinically relevant assessment criteria were selected, including volumetric overlap, Haussdorf-95, bony contact, ramus/symphysis angles, and dental implantability. In 2021, 21 consecutive patients undergoing mandibular reconstructions were consented to the study.

Towards transcervical ultrasound-guided transoral robotic surgery.

Background: In the context of transoral robotic surgery (TORS) for oropharyngeal squamous carcinoma (OPSCC), preoperative imaging and intraoperative visualization plays a pivotal role in optimizing resection margins. Prior work has demonstrated the ability of transoral ultrasound (US) in identifying OPSCC margins and vascular structures. This study evaluates the effectiveness of transcervical ultrasound (TUS), as well as other preoperative imaging modalities, in evaluating OPSCC volumes and compares this to post TORS pathological OPSCC volumes.

Intraoperative Real-Time Image-Guided Fibular Harvest and Mandibular Reconstruction: A Feasibility Study on Cadaveric Specimens.

Background: This study assesses the feasibility of real-time surgical navigation to plan and guide sequential steps during mandible reconstruction on a series of cadaveric specimens.

Methods: An image-guided surgical (IGS) system was designed including customized mandible and fibula fixation devices with navigation reference frames and an accompanied image-guided software. The mandibular and fibular segmental osteotomies were performed using the IGS in all five cadaveric patients.

Evaluating the benefit of virtual surgical planning on bony union rates in head and neck reconstructive surgery.

Objectives: Virtual surgical planning (VSP) has gained acceptance because of its benefits in obtaining adequate resection, achieving cephalometric accuracy, and reducing operative time. The aim of this study is to compare the rate of union between VSP and free-hand surgery (FHS), identify predictors of non-union and evaluate the difference in operative time.

Methods: Post-operative CT were retrospectively reviewed for 123 patients who underwent maxillary or mandibular reconstruction between 2014 and 2021 using either VSP or FHS.

Review of intravascular lithotripsy for treating coronary, peripheral artery, and valve calcifications.

Management of intracoronary calcium (ICC) continues to be a challenge for interventional cardiologists. There have been significant advances in calcium treatment devices. However, there still exists a knowledge gap regarding which devices to choose for the treatment of ICC.

Intravascular laser lithotripsy for calcium fracture in human coronary arteries.

Background: Electrical intravascular lithotripsy (E-IVL) uses shock waves to fracture calcified plaque.

Aims: We aimed to demonstrate the ability of laser IVL (L-IVL) to fracture calcified plaques in ex vivo human coronary arteries and to identify and evaluate the mechanisms for increased vessel compliance.

Methods: Shock waves were generated by a Ho:YAG (Holmium: yttrium-aluminium-garnet) laser (2 J, 5 Hz) and recorded by a high-speed camera and pressure sensor.

Incidence and complications of hypothyroidism postlaryngectomy: A systematic review and meta-analysis.

Background: Hypothyroidism is common postlaryngectomy and is associated with laryngectomy-specific complications. The objective of this study is to determine the incidence and predictors of hypothyroidism postlaryngectomy and its associated complications.

Methods: Systematic review, data extraction, and meta-analyses were performed following the PRISMA protocol.

Decisional regret, symptom burden, and quality of life following transoral robotic surgery for oropharyngeal cancer.

Background: Transoral robotic surgery (TORS) has equivalent oncologic control to radiotherapy with potential for improved quality of life (QOL) and lower patient-reported decisional regret.

Methods: Cross-sectional study between 2016 and 2021 of TORS patients with early-stage oropharyngeal squamous cell carcinoma who completed the Decision Regret Scale (DRS), M. D.

Current and Emerging Imaging Techniques for Neurofibromatosis Type 1-Associated Cutaneous Neurofibromas.

A consistent set of measurement techniques must be applied to reliably and reproducibly evaluate the efficacy of treatments for cutaneous neurofibromas (cNFs) in people with neurofibromatosis type 1 (NF1). cNFs are neurocutaneous tumors that are the most common tumor in people with NF1 and represent an area of unmet clinical need. This review presents the available data regarding approaches in use or development to identify, measure, and track cNFs, including calipers, digital imaging, and high-frequency ultrasound sonography.

Towards transcervical ultrasound image guidance for transoral robotic surgery.

Purpose: Trans-oral robotic surgery (TORS) using the da Vinci surgical robot is a new minimally-invasive surgery method to treat oropharyngeal tumors, but it is a challenging operation. Augmented reality (AR) based on intra-operative ultrasound (US) has the potential to enhance the visualization of the anatomy and cancerous tumors to provide additional tools for decision-making in surgery.

Methods: We propose a US-guided AR system for TORS, with the transducer placed on the neck for a transcervical view.

Erratum: Tissue harvest with a laser microbiopsy (Erratum).

[This corrects the article DOI: 10.1117/1.JBO.

Scattering angle resolved optical coherence tomography measures morphological changes in colonies.

Significance: An unmet need is recognized for early detection and diagnosis of neurological diseases. Many psychological markers emerge years after disease onset. Mitochondrial dysfunction and corresponding neurodegeneration occur before onset of large-scale cell and tissue pathology.

Tissue harvest with a laser microbiopsy.

Significance: Traditional pathology workflow suffers from limitations including biopsy invasiveness, small fraction of large tissue samples being analyzed, and complex and time-consuming processing.

Aim: We address limitations of conventional pathology workflow through development of a laser microbiopsy device for minimally invasive harvest of sub-microliter tissue volumes. Laser microbiopsy combined with rapid diagnostic methods, such as virtual hematoxylin and eosin (H&E) imaging has potential to provide rapid minimally invasive tissue diagnosis.

Er:YAG laser brain surgery with vascular specific coagulation.

Background And Objective: Erbium:yttrium-aluminum-garnet (Er:YAG) laser ablation can effectively resect water-bearing tissues. Application of Er:YAG resection in neurosurgery is complicated by unpredictable bleeding in surgical field. Recently, an integrated theranostic system combining a dual-wavelength laser surgery system using a thulium (Tm) fiber-laser for coagulation and Er:YAG for resection, combined with optical coherence tomography (OCT) guidance was demonstrated for the in vivo resection of tumor tissue.

Laser coagulation and hemostasis of large diameter blood vessels: effect of shear stress and flow velocity.

Photocoagulation of blood vessels offers unambiguous advantages to current radiofrequency approaches considering the high specificity of blood absorption at available laser wavelengths (e.g., 532 nm and 1.

Fiber-laser platform for precision brain surgery.

Minimally invasive neurological surgeries are increasingly being sought after for treatment in neurological pathologies and oncology. A critical limitation in these minimally invasive procedures is lack of specialized tools that allow for space-time controlled delivery of sufficient energy for coagulation and cutting of tissue. Advent of fiber-lasers provide high average power with improved beam quality (lower M), biocompatible silica fiber delivery, reduced cost of manufacturing, and radiant output stability over long operating periods.

Validation of the novel Deep Reality Viewer (DRV) 3D digital stereo viewer in otology surgery.

Purpose: Magnification with accurate optic reproduction of the surgical field is essential in otology surgery, but current technologies are subject to specific disadvantages. This study aims to evaluate a novel 3D digital stereo viewer, the Deep Reality Viewer (DRV), in otology surgery, in comparison to both a 2D monitor and the gold standard of microscopy.

Methods: In this prospective clinical research study, ENT consultants and trainees evaluated visual and practical applications of the DRV.