1.06-μm Nd:YAG laser coagulation tonsillectomy: an animal study

Tonsillectomy is one of the most frequently performed surgeries which is not free from post- operative morbidity. We have developed a non contact photocoagulation technique using 1.06 micrometers Nd:YAG laser and tested its safety and efficacy in an animal model. Eight animals were divided into the laser coagulation group (6 animals) and the laser excision group (2 animals). Tonsils of the laser coagulation animals were irradiated with 8 - 10 W of laser power for 5 - 6 min in a slow painting-like motion over the surface of a tonsil until slight blanching of mucosa was noticed. Tonsils of the laser excision group were resected with 25 - 30 W of 1.06 micrometers Nd:YAG laser power through a contact fiber. The animals were examined endoscopically at 1.5 hrs and at 2, 5, 12, 30, and 42 days post treatment. Atrophic process was followed until total disappearance of tonsillar tissue was observed. The animals were sacrificed at various time intervals and the tonsillar specimens were collected for gross and histological examination. The thermal damage to mucosa and adjacent tissues was minimal which we attribute to a low laser power and cooling from preoperative injection of saline into subcapsular space. The potential advantages of this technique include intact mucosa with no intra- or post-operative bleeding, less pain, and avoidance of general anesthesia. These advantages may enable this surgery to become an in-the-office procedure.