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Here, we describe for the first time the fabrication of laser‐induced graphene (LIG) electrodes on a hybrid substrate composed of sandpaper and polyester. As a proof of concept, the proposed device was used as a voltammetric sensor for tadalafil (TAD) quantification in authentic tablet samples. The electrochemical TAD sensing based on differential pulse voltammetry (DPV) revealed a linear behavior in the concentration range from 25 to 250 μmol L−1(R2=0.99), a limit of detection of ~9.6 μmol L−1, sensitivity of ~0.0048 μA(μmol L−1)−1 and acceptable reproducibility values (RSD≤5.8 %). The DPV responses involving the standard addition method in pharmaceutical samples presented recovery results of TAD ranging from 93 to 108 %. Also, the proposed analytical method offered a suitable green analytical chemistry profile. We successfully demonstrated the fabrication of graphene‐like sites and nanoparticles composed of alumina upon a hybrid substrate. [ABSTRACT FROM AUTHOR]

Yttrium‐stabilized zirconia (YSZ) plays a crucial role in thermal barrier coatings widely used to protect metallic components in gas turbine engines against high‐temperature combustion product gases and harsh environments. The thermal conductivity of these coatings is a critical parameter influencing the gas turbine design, performance, and service life. In this study, a laser temperature gradient method is utilized to measure the thermal conductivity of porous YSZ coatings. The method employs specialized laser energy delivery to create a one‐dimensional temperature gradient through the sample thickness, closely simulating the operational condition. This approach provides an effective, direct means to determine the thermal conductivity of high‐temperature heat‐resistant porous ceramic materials. [ABSTRACT FROM AUTHOR]

Introduction: High‐flow nasal oxygen (HFNO), or transnasal humidified rapid‐insufflation ventilatory exchange (THRIVE), is a technique providing apneic oxygenation and a degree of ventilation during microlaryngeal surgery. Its use with laser has been questioned due to concern for airway fire. For fire to occur, a triad of ignition source, oxidizer, and fuel source must be present. By using HFNO and eliminating an endotracheal tube (fuel source), it is hypothesized that airway fire risk is minimal. We tested this theory with human cadavers using HFNO with increasing levels of FiO2 while performing microlaryngeal laser surgery. Methods: HFNO was placed on two cadavers, and oxygen was administered at incrementally increasing fraction of inspired oxygen (FiO2) concentrations (30%–100%). Laryngeal microsurgery was conducted with CO2 and KTP lasers applied for 30 s. Oxygen readings were taken at several anatomic locations along the body assessing oxygen concentrations in correlation with increasing FiO2 administration. Results: The use of CO2 and KTP laser on cadaveric vocal folds produced char but no spark or airway fire at any of the tested oxygen concentrations. Apart from the mouth, there was minimal increase in oxygen levels at the surrounding anatomic sites despite elevating FiO2 levels. Conclusion: HFNO may be safe to use during microlaryngeal laser surgery. By eliminating the endotracheal tube as a fuel source, risk of airway fire may be negligible. Our study safely applied CO2 and KTP lasers for an uninterrupted 30 s with HFNO at 70 L/min and 100% FiO2 producing no spark or fire. Level of Evidence: NA Laryngoscope, 135:223–226, 2025 [ABSTRACT FROM AUTHOR]

Objective: Analyze the duration of symptom‐free intervals following laser wedge excision (LWE) for recurrent idiopathic subglottic stenosis (iSGS). Secondary aim includes evaluating the influence of patient‐related or disease factors. Study Design: Retrospective review. Setting: Tertiary center. Methods: Review of iSGS patients who underwent LWE between 2002 and 2021. LWE patients without prior airway surgery were labeled LWE primary (LWEP) and those with prior history of dilation were labeled LWE secondary (LWES). A conditional frailty repeated events model was used to analyze the median time to recurrence (MTR) for each nth recurrence. Secondary analysis included stratification by use of medical therapy and initial preoperative characteristics of scar (Myer‐Cotton grade, distance between the glottis and superior‐most aspect of scar, DGS; length of scar, DL). Results: Two hundred and ten iSGS patients underwent LWE (131 LWEP, 79 LWES). The proportion of patients experiencing at least 1, 3, 6, and 12 recurrences, respectively, was 68.0% (n = 143), 40.7% (n = 85), 20.0% (n = 42), and 5.2% (n = 11). There was exponential time‐shortening from the 1st to 12th recurrence (P <.0001). While MTR was 4.1 years after the first LWE, this fell to 2.8, 1.7, 1.0, and 0.7 years for the 2nd, 3rd, 6th, and 12th recurrences. Furthermore, LWEP patients experienced longer MTR than LWES counterparts within the first 6 recurrences (P <.01). There was no significant relationship between intersurgical interval and medication adherence, DL, DGS, or grade for recurrences beyond the first (P =.207, P =.20, P =.43, P =.16). Conclusion: Symptom‐free intervals in iSGS shorten with each subsequent recurrence and LWE. The difference in MTR between LWEP and LWES groups was significant within the first 6 recurrences with LWEP having longer MTR. Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

Objective: Endoscopic management of subglottic stenosis (SGS) includes a wide range of techniques. This 17‐year review compares treatment outcomes between carbon dioxide (CO2) laser and cold steel. Study Design: Retrospective chart review. Setting: Single tertiary care center. Methods: A chart review was performed for all patients undergoing endoscopic treatment of SGS at Cleveland Clinic between July 12, 2000 and September 1, 2017. Data collected included demographics, stenosis etiology, stenosis severity, comorbidities, treatment modality, and airway procedure history. The primary endpoint was repeated treatment‐free survival (RTFS) within 2 years using a Kaplan‐Meier analysis and Cox proportional hazard model. Results: A total of 139 patients (median [interquartile range] aged 48.7 [37.8, 57.0] years; 83.4% female) were included in the analysis, with etiologies including idiopathic (56.8%), granulomatosis with polyangiitis (25.2%), and intubation (16.5%). All patients underwent either cold steel (107 patients) or CO2 laser (32 patients) lysis of stenosis with concurrent dilation. RTFS within 2 years was 50.2% for CO2 laser and 31.9% for cold steel (hazard ratio [HR] and 95% confidence interval [CI]: 1.69, 0.96‐2.97, P =.07). In patients with no prior airway procedures, there was no difference in RTFS between laser and cold knife (P =.41). However, in patients with prior airway procedures, RTFS was significantly greater in the laser group, even after adjusting for age, smoking history, and stenosis etiology (50.0% vs 16.8%, adjusted HR and CI: 2.82, 1.14‐6.98, P =.025). Conclusion: Endoscopic lysis of SGS with CO2 laser should be considered in revision cases. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the effectiveness of carbon dioxide (CO2) laser vaporisation versus intralesional injection of triamcinolone acetonide (TA) in the management of oral lichen planus (OLP). Methods: A randomised clinical trial with a split‐mouth design was conducted on 16 patients with bilateral symptomatic OLP lesions. One side was treated with CO2 laser vaporisation, and the counterpart was treated with TA intralesional injection. The reticular–erythematous–ulcerative (REU) score, Thongprasom sign scoring (TSS), visual analogue scale (VAS) and lesion area were used to evaluate the lesions at weeks 0, 4 and 9. All participants were followed up for 9 months. Results: Reduction in the REU, TSS scores and lesion area from baseline to the end of treatment was significantly greater in the CO2 group than in the TA group (p values were 0.001, 0.002 and 0.048 respectively). However, the reduction in VAS score did not differ between the two groups (p = 0.54). The recurrence rate was significantly higher in the TA group than in the CO2 group (75% vs. 31.1%; p = 0.016). Conclusions: CO2 laser vaporisation was more effective than TA intralesional injection in managing OLP and decreased recurrence rates. [ABSTRACT FROM AUTHOR]

Aim: To characterize the effects of CO2 laser treatment and estrogen treatment on vaginal microbiota in patients with genitourinary syndrome of menopause (GSM). Methods: Sixty‐four patients with genitourinary syndrome were divided into the estrogen group, the CO2 laser group, and the control group. The control group did not receive any treatment. Vaginal mucosa was collected after 3 and 12 months of treatment. The former was used for 16S rRNA sequencing, and the latter was used for pathological evaluation. Vaginal health and voiding function were assessed using the vaginal health index (VHI) scale and the UDI‐6 scale at 3 and 12 months after treatment. Results: The results showed that both treatments reduced alpha diversity in the vaginal flora. Additionally, the abundance of 65 genera differed significantly between the treatment and control groups, with an increase in potentially beneficial bacteria such as Lactobacillus, IheB3_7, Mycoplasma urealyticum, and Streptococcus. In addition, the VHI and UDI‐6 scores improved in both treatment groups compared to the control group after 3 months. Whereas VHI and UDI‐6 scores were close to baseline in the estrogen group, and remained significantly improved in the CO2 laser group after 12 months. Pathological results showed that both methods improved the vaginal health status of patients with GSM after 12 months of treatment. However, the CO2 group exhibited a more significant increase in type III collagen. Conclusions: Both CO2 laser and estrogen therapies can regulate the vaginal flora imbalance of GSM and improve the corresponding symptoms. However, the long‐term efficacy of CO2 laser therapy is superior compared to estrogen therapy. [ABSTRACT FROM AUTHOR]

Laser‐assisted drug delivery (LADD) is a treatment method to enhance the penetration of pharmaceuticals through the skin. The aim of the present study is to track hyaluronic acid (HA) and analyse its effect on human skin in vivo after ablative fractional laser (AFL) treatment. Healthy male and female subjects were recruited. Four areas were marked on their forearms of each volunteer, and each area was assigned to one of the following treatment options: AFL + HA, AFL only, HA only or untreated control. A carbon dioxide laser was used for the AFL treatment. Follow‐up measurements were scheduled 30 min and 30 days after treatment using multiphoton tomography equipped with fluorescence lifetime imaging (MPT‐FLIM). A total of 11 subjects completed the study. By detecting fluorescence lifetimes, the HA and the anaesthetic ointment were clearly distinguishable from surrounding tissue. After AFL treatment, HA could be visualized in all epidermal and upper dermal layers. In contrast, HA in intact skin was only detected in the superficial layers at distinctly lower levels. The applied HA gel seemed to have beneficial properties for the wound healing process after laser treatment. LADD has proven to be a fast and effective method to increase HA uptake into the skin, allowing for improved hydration and skin rejuvenation over time. Furthermore, LADD could be a beneficial treatment option in laser resurfacing. MPT‐FLIM proved to be an appropriate diagnostic tool for drug delivery tracking and monitoring of treatment response for individualized therapy adjustment. [ABSTRACT FROM AUTHOR]

Objectves: Different surface preparation and treatment methods may have dissimilar effects on the microleakage of composite resin. This study was conducted to determine the deproteinizing effect of 10% bromelain enzyme, 10% papain enzyme, CO2, and erbium‐YAG laser in regard to decrease in the microleakage of composite restorations. Materials and Methods: Thirty teeth were selected and 60 class V cavities were prepared on the lingual and buccal sides. They were divided into six groups (n = 10): Group 1, phosphoric acid gel; Group 2, bromelain enzyme 10%; Group 3, papain enzyme 10%; Group 4, mixed papain and bromelain enzymes 10%; Group 5, CO2 laser; and Group 6, erbium‐YAG laser. They were stored in basic fuchsine and dye penetration was evaluated. Kruskal–Wallis and Mann–Whitney tests were used for statistical analysis, p < 0.05 Results: In both occlusal and gingival margins, comparison of microleakage between groups 1, 2, 3, 4, and 5 showed no significant differences (p = 1) and group 6 had a significant difference with other groups (p ˂ 0.001). Conclusions: Microleakage of composite resin in the dentin surface was not affected significantly using either bromelain or papain 10% enzymes or erbium laser. However, CO2 laser had a negative effect on the enamel and dentin margins and increased the microleakage. Erbium laser showed a better effect than enzymes on microleakage. [ABSTRACT FROM AUTHOR]

Background: Treatments currently available for ceruminous gland tumors include surgery and radiation therapy, which come with high financial costs and frequent complication and recurrence rates. Hypothesis: To evaluate the treatment, response, complication, and recurrence of ceruminous gland tumors confirmed with biopsy and ablated using CO2 laser. Methods: Retrospective review of medical records from Iowa State University and the University of Illinois between January 1, 2016 and December 31, 2021. Electronic medical records were evaluated for a histopathologically confirmed ceruminous gland tumor via video‐otoscopic aided biopsy and subsequent CO2 laser ablation. Signalment, tumor type, size, location within the ear canal, length of time tumor was present before presentation, advanced imaging, and follow‐up including recurrence were assessed. Results: Fourteen ceruminous gland adenomas (4 dogs, 10 cats) and 12 ceruminous gland adenocarcinomas (7 dogs, 5 cats) were identified. Bacterial otitis externa was present in 4/26 (15%) animals. Recurrence was identified in 1/14 (7%) ceruminous gland adenomas and 1/12 (8%) ceruminous gland adenocarcinomas. Conclusions and Clinical Importance: Video‐otoscopic aided biopsy and CO2 laser ablation of ceruminous gland tumors in dogs and cats is a viable treatment option with low recurrence and complication rates with CO2 laser ablation. [ABSTRACT FROM AUTHOR]

Objective: Endoscopic Zenker's diverticulotomy (EZD) is typically performed via stapling (endoscopic staple diverticulotomy; ESD) or CO2 laser (endoscopic laser diverticulotomy; ELD). Conflicting reports exist on which approach provides optimal outcomes. This investigation compared objective fluoroscopic data between ESD and ELD. Methods: A retrospective review of all patients undergoing primary EZD at a tertiary center between January 1, 2014 and January 10, 2022 was performed. Patients undergoing ESD and ELD were matched by preoperative diverticulum size. Primary outcome measures were postoperative diverticulum size and change in diverticulum size from pre‐ to postoperative swallowing fluoroscopy. Secondary outcome measures were the Eating Assessment Tool (EAT‐10) score, penetration aspiration scale (PAS), pharyngeal constriction ratio (PCR), and pharyngoesophageal segment opening (PESo). Results: Thirteen matched pairs with complete fluoroscopic data were identified. The mean (±SD) age of the cohort was 74.0 (±8.5) years. There were no age or gender differences between groups (p > 0.05). The mean pre‐operative ZD size was 1.98 (±0.69) cm for ESD and 1.97 (±0.72) cm for ELD; the mean postoperative size was 0.84 (±0.62) cm for ESD and 0.34 (±0.27) cm for ELD (p < 0.05). Mean diverticulum size improved by 1.14 (±0.59) cm after ESD and 1.62 (±0.59) cm after ELD (p < 0.05). There were no significant differences in postoperative EAT‐10, PAS, PCR, or PESo between groups. Conclusion: The data suggest that endoscopic laser Zenker's diverticulotomy results in a greater improvement in diverticulum size than endoscopic staple diverticulotomy. The data did not suggest a difference in postoperative dysphagia symptom scores or other objective fluoroscopic parameters between staple and laser diverticulotomy. Level of Evidences: Level 3 Laryngoscope, 133:3057–3060, 2023 [ABSTRACT FROM AUTHOR]

Heck's disease or multifocal epithelial hyperplasia (MEH) is an uncommon asymptomatic contagious oral condition, usually attributed to human papillomavirus (HPV) infection. It manifests as several smooth papules and nodules in the oral mucosa. The disease has a good prognosis, as it is spontaneously regressing, but some cases persist and affect the quality of the patient's life, requiring therapeutic intervention. We present an unusual case of extensive multifocal epithelial hyperplasia. To the best of our knowledge, this is the first case to be reported with this severity and widespreadness of the lesions. A 14‐ year‐old girl was referred to the department of oral medicine at the faculty of dental medicine, with a chief complaint of numerous nodules and papules, appeared since she was 6 years old. The diagnosis of Heck's disease was confirmed depending on clinical characteristics, histopathological examination and immunohistochemical (IHC) staining. Human immunodeficiency virus (HIV) antibodies test and enzyme‐linked immunosorbent assay (ELISA) for human papillomavirus Immunoglobulin G (IgG) were performed. Depending on the extensive clinical situation, the decision was made to treat the patient using carbon dioxide (CO2) laser. Heck's disease is a human papillomavirus‐related oral condition. The diagnosis can be confirmed depending on both clinical and histopathological characteristics in addition to immunohistochemical staining. In this case, CO2 laser showed good functional and aesthetic results that reflected positively on the quality of the patient's life. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effect of transoral CO2 laser‐modified posterior cordotomy combined with plasma ablation subtotal arytenoidectomy for bilateral vocal fold paralysis (BVFP). Design: A retrospective study with medical records from 2017 to 2021 in our hospital. Setting: A single‐centre study. Participants: This retrospective study included 22 patients with BVFP. They underwent transoral CO2 laser‐modified posterior cordotomy combined with plasma ablation subtotal arytenoidectomy in our hospital from 2017 to 2021. Main Outcome Measures: Preoperative and postoperative swallowing and phonation functions were evaluated in all patients. Results: All 22 patients with a tracheostomy were successfully decannulated within 6 months after surgery without subsequent revision operations, and the width of the posterior glottis was more than 3.9 mm in all patients when they inspired. The statistical analysis showed that there was no difference in vocal function and swallowing function in all patients compared to preoperative (p >.05). Conclusion: Transoral CO2 laser‐modified posterior cordotomy combined with plasma ablation subtotal arytenoidectomy enlarges the posterior glottis in patients with BVFP, which maintains airway patency without significant worsening in voice and swallowing function. [ABSTRACT FROM AUTHOR]

Objectives: Granular myringitis (GM) is a troublesome disease with a high incidence of recurrence and relapse. CO2 laser vaporisation and trichloroacetic acid (TAA) have been applied in treating several otological diseases, both with favourable therapeutic efficacy. However, long‐term therapeutic efficacy of both CO2 laser vaporisation and TAA cauterisation against GM has not yet been evaluated. We aimed to investigate the therapeutic potential of CO2 laser vaporisation and TAA cauterisation in GM management. Study Design: Prospective and randomised study. Participants: A total of 88 GM patients who failed therapy with boric acid, alcohol and glycerin ear drop otic solution between July 2009 and January 2018 were included. Participants were randomly assigned to receive CO2 laser vaporisation (n = 39) or TAA cauterisation (n = 49). Main Outcome Measures: Main outcomes were treatment success, complications after 4 months of treatment, and recurrence within 4–12 months after treatment. Results: The success rate was significantly higher in the CO2 group than in the TAA group (94.9% vs. 77.6%, p =.023). After 4 months of treatment, the GM recurrence rate was comparable between the two groups (13.5% vs. 18.4%, p =.562). The CO2 laser group had one case of perforation and one case of severe vertigo, whereas one participant in the TAA cauterisation group experienced hearing loss. Conclusion: Both TAA cauterisation and CO2 laser vaporisation are safe and effective treatments for GM. The success rate of CO2 laser vaporisation for treating GM is higher than that of TAA cauterisation. Recurrence rates are comparable within 1 year. [ABSTRACT FROM AUTHOR]

Introduction: Recalcitrant oral lesions of pemphigus vulgaris (PV), an autoimmune blistering disease, can result in significant discomfort, difficulty in eating, and maintaining oral hygiene. Increasing the dosage of systemic medications to control such localized lesions results in an increased risk of adverse effects. Case Presentation: We describe a male patient diagnosed at age 51 with PV by oral biopsy that included a direct immunofluorescence examination. After further baseline laboratory testing, he was started on prednisone and mycophenolate. These medications were slowly tapered with adjustments guided by clinical signs. Mycophenolate was replaced with intravenous immunoglobulin monthly infusions due to adverse effects about 2 years after initiation. During the 4.5‐year follow‐up period after diagnosis, his oral and skin lesions were well‐controlled apart from minor transient flares. However, a painful ulcerated lesion on the facial gingiva between #11 and 12 was nonresponsive, even with the use of topical clobetasol in trays. A carbon dioxide (CO2) laser was used to vaporize the recalcitrant lesion under local anesthesia. The procedure resulted in complete healing of ulceration with no recurrence until the most recent examination, 2 years postlaser surgery. Conclusion: Adjunctive procedures that can facilitate a decrease in the cumulative dosage of corticosteroids and immunosuppressants have great value in the management of PV. CO2 laser vaporization is safe, with minimal morbidity and no long‐term side effects. It should be considered an adjunctive treatment option for the management of recalcitrant lesions in patients with oral PV. Key points: Why is this case new information? To our knowledge, this is the second report on the use of a CO2 laser in the treatment of recalcitrant oral lesions of PV and the first report with a documented long‐term resolution of the treated lesions. What are the keys to the successful management of this case? A localized recalcitrant lesion was treated with this approach. All other mucosal and cutaneous sites were well controlled on the patient's systemic medication regimen. What are the primary limitations to success in this case? This approach is only relevant for the management of recalcitrant lesions in patients whose disease activity is otherwise well controlled. The availability of specialized equipment and trained clinicians is necessary. [ABSTRACT FROM AUTHOR]

Purpose: Usually, in stress urinary incontinence (SUI), nonsurgical therapy such as pelvic floor muscle training (PFMT) and lifestyle changes are proposed before surgical treatment. Laser therapy has recently been recommended for the treatment of SUI, helping to reconstruct the collagen that supports the vagina and the pelvic floor. The aim of the study was to evaluate the efficacy of SUI treatment with a CO2 intravaginal laser in patients waiting for anti‐incontinence surgery (TVT‐O). Methods: This is a prospective, case–control study. Fifty‐two patients have been included in our study and we divided them into two groups: atrophy and no atrophy. We also adopted a control group retrospectively identified from our database of patients undergoing PFMT. The subjective estimation of SUI symptoms before and after treatment was evaluated using the Visual Analog Scale before and after 1, 6, and 12 months of treatment. The objective evaluation with the urodynamic study with the stress test and a 3‐day voiding diary to count the number of episodes of incontinence, before and after treatment. Results: The intravaginal CO2 laser improved all the parameters considered for SUI in both groups. Its results were more relevant in the atrophy group, in comparison to the no atrophy group, even if they were both statistically significant. There were no statistically significant differences for all the parameters evaluated for SUI between laser treatment and PFMT in the control group. Conclusion: The CO2 laser is well‐tolerated, minimally invasive, safe, and showing efficacy for SUI. More studies are needed to consider it as first‐instance therapy, like PFMT, or at least, as a bridge therapy to surgery. [ABSTRACT FROM AUTHOR]

Objective: Effective bond strength of composite resin restoration leads to its durability, so evaluation of dentin surface treatment with enzymes and laser for higher bond strength is an important factor. Materials and Methods: Sixty human molar teeth were cut at a depth of 2 mm of occlusal part and divided into six groups (n = 10). G1: etched with 37% phosphoric, G2 and G3: 10% papain or bromelain enzymes were used on the dentinal surface, G4: 10% papain and bromelain enzyme mixture were used for. Then, the specimens were washed with distilled water. In G5 and G6: Er:YAG or Co2 lasers were used on the dentin surface. An adhesive system was applied and then nanohybrid composite was placed in teflon mold and light cured. Samples were subjected to a shear bond strength (SBS) test by universal testing machines. Statistical analysis was performed, using one‐way analysis of variance and Tukey HSD tests (p <.05). Results: The mean SBS in G1 was significantly higher in comparison with the other groups (p <.0001). On the other hand, a comparison of mean SBS between groups 2, 3, 4, and 5 shows no significant differences (p =.221). The mean SBS in group 6 (Co2 laser) was significantly lower in comparison with the other groups (p <.0001). Conclusion: Results showed that SBS of composite resin to dentin was not significantly affected, using either bromelain or papain 10% enzymes or erbium laser. Co2 laser had a negative effect on dentin and decreased the SBS. Phosphoric acid has the best result. [ABSTRACT FROM AUTHOR]

All these procedures may be combined with additional stenting or (local) medical therapy.1 Historically, for subglottic stenosis, we performed dilatation tracheoscopy using the Groningen Dilatation Tracheoscope (Karl Storz GmbH & Co, Tuttlingen, Germany).2 During this dilatation tracheoscopy, ventilation of the airway distal to the stenosis is maintained through the tracheascope. A recent study concludes that SSHFJV is physically tolerated by almost every patient and is found to be safe, even in patients with severe cardiovascular and pulmonary comorbidities.5 We are not aware of a ventilation technique, other than SSHFJV, that would allow the use of the Trachealator balloon. To conclude, with this case series we show that CO SB 2 sb laser incision combined with Trachealator balloon dilation and SSHFJV seems to be an effective and safe treatment combination for patients with subglottic stenosis when looking at short term effects. Keywords: subglottic stenosis; supraglottic superimposed high-frequency jet ventilation; non-occlusive balloon dilatation; Trachealator; CO2 laser EN subglottic stenosis supraglottic superimposed high-frequency jet ventilation non-occlusive balloon dilatation Trachealator CO2 laser 2202 2205 4 10/19/22 20221101 NES 221101 INTRODUCTION Subglottic stenosis is a severe and, when progressive, life-threatening condition. [Extracted from the article]

Oxygen species functionalized graphene (O−G) is an effective electrocatalyst for electrochemically synthesizing hydrogen peroxide (H2O2) by a 2 e− oxygen reduction reaction (ORR). The type of oxygen species and degree of carbon crystallinity in O−G are two key factors for the high catalytic performance of the 2 e− ORR. However, the general preparing method of O−G by the precursor of graphite has the disadvantages of consuming massive strong oxidant and washing water. Herein, the biomass‐based graphene with tunable oxygen species is rapidly fabricated by a CO2 laser. In a flow cell setup, the laser‐induced graphene (LIG) with abundant active oxygen species and graphene structure shows high catalytic performance including high Faraday efficiency (over 78 %) and high mass activity (814 mmolgcatalyst−1 h−1), superior to most of the reported carbon‐based electrocatalysts. Density function theory demonstrates the meta‐C atoms at nearby C−O, O−C=O species are the key catalytic sites. Therefore, we develop one facile method to rapidly convert biomass to graphene electrocatalyst used for H2O2 synthesis. [ABSTRACT FROM AUTHOR]

Background: Striae gravidarum (SG) is a connective tissue disorder seen commonly in primigravidas. It is associated with impairment in the quality of life. Objective: To determine the efficacy of ablative fractional carbon dioxide (CO2) laser combined with autologous platelet‐rich plasma (PRP) versus ablative fractional CO2 laser and placebo in the treatment of SG. Study design: Randomized, double‐blinded, and placebo‐controlled trial. Methodology: The study was conducted in 16 patients with SG. The assigned treatment area (abdomen) was divided into two sides and was randomly assigned to the PRP side and the control side. All patients received ablative fractional CO2 laser. Immediately after each laser procedure, the PRP side received autologous PRP, while the control side received plain normal saline solution (pNSS) as a placebo. The study was done for three sessions, at intervals of 4 weeks. An independent assessor used the photographs taken at Weeks 6, 10, 14, and 16 to assess the clinical improvement. The patient satisfaction was reported at the same intervals. A quartile grading scale was used to measure both the clinical improvement and patient satisfaction. Data were analyzed using the Jonckheere–Terpstra test. Histopathology was done before treatment and at the end of the study period. Results: The combination of ablative fractional CO2 laser and autologous PRP had better clinical improvement and patients' satisfaction compared with ablative fractional CO2 laser and placebo. However, both outcome measures were not statistically significant. Conclusion: Ablative fractional CO2 laser combined with autologous PRP appears to be an effective treatment in SG. [ABSTRACT FROM AUTHOR]

Striae Distensae (SD) are quite common complaint in dermatology practice. They are linear lesions of variable length and width according to the site and the causative condition. Several treatment modalities have been tried. To achieve satisfactory results, a combination therapy is often needed. To evaluate the efficacy and safety of fractional CO2 laser versus carboxytherapy in the treatment of Striae Distensae clinically and radiologically. Thirty Egyptian patients with striae distensae, received a split body therapy: the left side was treated by fractional CO2 laser and the right side was treated by carboxytherapy in the same session. Six sessions were done with 4 weeks apart. Clinical evaluation by measurement of the width of widest striae on both sides, global aesthetic improvement scale (GAIS), and Likert satisfaction scale. Radiological evaluation by measurement of cutaneous thickness of widest striae on both sides by ultrasonography. There was a highly statistically significant decrease in the median width of the widest striae distensae on both sides after the last session (P < 0.01). Regarding GAIS, satisfaction scale and ultrasound, there was highly statistically significant improvement on laser side than carboxytherapy side (P < 0.01) after last session. Both fractional CO2 laser and carboxytherapy may be considered as safe and effective lines of treatment for striae distensae, but fractional CO2 laser showed excellent improvement clinically, radiologically when compared with carboxytherapy which made it a promising module in treatment of striae distensae. [ABSTRACT FROM AUTHOR]

Carbon dioxide (CO2) lasers are used for a variety of soft tissue procedures. This report describes their use in dermatitis associated with feline herpesvirus‐1 (FHV) in two cheetahs. To the best of the authors' knowledge, this is the first report describing CO2 laser use to adjunctively treat FHV‐associated skin lesions. [ABSTRACT FROM AUTHOR]

Objective: The CO2 laser and 532 nm potassium titanyl phosphate (KTP) laser have been applied to treat recurrent respiratory papillomatosis (RRP). This systematic review sought to compare outcome differences between these two methods. Data Sources: Embase, Web of Science, PubMed, and the Cochrane Library. Review Methods: CO2 laser and KTP laser studies were obtained by keyword searches of four authoritative medical databases. Articles were screened and retained when conforming to inclusion criteria. The primary outcome was cure rate; the secondary outcomes were recurrence, death, remission, clearance, and human papillomavirus (HPV)‐detected rates, as well as laser effectiveness rates. Postoperative complications rate was the safety outcome measure. All outcomes were summarized within the CO2 and KTP groups, with results statistically compared (p <.05). Results: Overall, the cure rates were 87.25% (KTP group) and 75.98% (CO2 group; p <.05). Complication rates significantly differed between the KTP (2.32%) and CO2 (17.71%) groups (p <.0001). There was a relatively higher but not significant difference in the recurrence rates between the CO2 (18.6%) and KTP (10.87%) groups (p =.1595). The CO2 group remission rate was considerably lower (38.9%) than the KTP group (88.46%, p <.0001). HPV‐detected and clearance rates were only reported for the CO2 group. The bias risks were 13.1 ± 1.45 (CO2) and 13.6 ± 1.52 (KTP) for the two groups, indicating evidence was of fair quality. Conclusion: Overall, KTP laser excision showed significantly better postoperative clinical outcomes than the CO2 laser, with a lower failure rate. Available fair‐quality evidence suggests KTP laser excision might be better for treating RRP. Nevertheless, more high‐quality randomized controlled studies are needed to compare these two surgical techniques, particularly in terms of reporting functional data such as vocal outcomes. [ABSTRACT FROM AUTHOR]

Objective: Build a microlaryngoscopy surgical simulator for endoscopic laryngeal surgery using standard microsurgical instruments and a CO2 laser. Study design: Anatomical modeling, CAD design and 3D printed manufacturing. Subjects and methods: We created a modular design for a microlaryngoscopy simulator in CAD software. Components include plastic and stainless‐steel models of a standard operating laryngoscope and a cassette system for mounting porcine or synthetic models of the vocal folds. All simulator parts, including the metallic laryngoscope model, were manufactured using 3D printing technology. Tumors were simulated in porcine tissue models by injecting a soy protein‐based tumor phantom. Residents and faculty in the Louisiana State University otolaryngology department evaluated the system. Each participant performed microlaryngoscopy with laser resection on a porcine larynx and cold instrument procedures on synthetic vocal folds. Participants scored the simulator using a 5‐point Likert scale. Results: The microlaryngeal surgical simulator demonstrated in this project is realistic, economical, and easily assembled. We have included 3D printed parts files and detailed assembly instructions that will enable educators interested in surgical simulation to build the device. Participants in the simulator evaluation session felt that the simulator faithfully represented the procedure to resect vocal fold lesions using a CO2 laser. The synthetic model allows the trainee to develop hand‐eye coordination while using standard laryngeal instruments. Conclusions: The simulator described herein will enable surgeons to acquire the surgical skills necessary to perform operative microlaryngoscopy prior to operating on live patients. [ABSTRACT FROM AUTHOR]

In recent years, LASER has been introduced as a minimally invasive treatment for a broad range of vaginal and vulvar symptoms and diseases. However, the efficacy and safety of vaginal and vulvar LASER has continuously been questioned. The aim of this study is to create an overview of the current literature and discuss the controversies within the use of LASER for genitourinary syndrome of menopause, vulvovaginal atrophy, urinary incontinence and lichen sclerosus. A search string was built in PubMed. The search was commenced on August 25, 2021 and closed on October 27, 2021. Two authors screened the studies in Covidence for inclusion according to the eligibility criteria in the protocol. The data were extracted from the studies and are reported in both text and tables. This review included 114 papers, of which 15 were randomized controlled trials (RCTs). The effect of LASER as a vaginal treatment was investigated for genitourinary syndrome of menopause in 36 studies (six RCTs), vulvovaginal atrophy in 34 studies (four RCTs) and urinary incontinence in 30 studies (two RCTs). Ten studies (three RCTs) investigated the effect of vulvar treatment for lichen sclerosus. Half of the included RCTs, irrespective of indication, did not find a significant difference in improvement in women treated with vaginal CO2 or Er:YAG LASER compared with their respective controls. However, most non‐comparative studies reported significant improvement after exposure to vaginal or vulvar LASER across all indications. Included studies generally had a short follow‐up period and only a single RCT followed their participants for more than 6 months post treatment. Adverse events were reported as mild and transient and 99 studies including 51 094 patients provided information of no serious adverse events. In conclusion, this review found that the effect of vaginal and vulvar LASER decreases with higher study quality where potential biases have been eliminated. We therefore stress that all patients who are treated with vaginal or vulvar LASER should be carefully monitored and that LASER for those indications as a treatment should be kept on a research level until further high‐quality evidence is available. [ABSTRACT FROM AUTHOR]

Background: Some basal cell carcinoma (BCC) patients are considered as a high risk regarding the site, size, histopathological variant, or recurrence. High‐risk BCC is a challenging therapeutic problem due to the trial to balance between complete surgical excision from one side and tissue preservation from the other side. Aim: To evaluate the efficacy of combining ablative CO2 laser, imiquimod 5%, and diclofenac 3% as a therapeutic regimen in high‐risk and inoperable BCC. Patients/Methods: The study was conducted on 14 patients that were assessed clinically and pathologically then categorized regarding the site, size, histopathology, and fitness for surgery as high‐risk inoperable BCC. They received an ablative session of CO2 laser, followed by application of diclofenac sodium 3% gel once daily for 5 days and imiquimod 5% cream for another 2 days. Results: The study included 11 males and 3 females. Nine lesions were located on the scalp, 4 on the face, and one lesion on the trunk. All lesions were of large size >5 cm in diameter. Histopathology showed 4 patterns: nodular type in 8 patients, infiltrating type in 3 patients, metatypical type in 2 patients, and micronodular type in one patient. At the end of the treatment period, 9 patients showed significant (moderate to marked) improvement while 5 patients showed weak (poor to mild) response. Significant improvement was more observed in nodular type. Relapse was more observed during the 5th to 6th months with 2 patients showed no relapse. Conclusion: This combined regimen is a good alternative therapeutic modality in high‐risk inoperable BCC especially the nodular pathologic pattern. [ABSTRACT FROM AUTHOR]

Background: Treatment of acanthosis nigricans (AN) is challenging, and new modalities are being explored continuously to increase the therapeutic efficacy. Aim: To evaluate the efficacy and safety of fractional CO2 laser compared to trichloroacetic acid (TCA) peel in the treatment of pseudo‐acanthosis nigricans (pseudo‐AN). Methods: The study included 40 patients with pseudo‐AN on the neck and axilla allocated into two groups each containing 20 patients. Group (A) was treated with TCA 20% peel applied on the pigmented area while group (B) received fractional CO2 laser. Both treatments were performed till complete clearance or for a maximum of four treatment sessions. Patients with excellent response were further followed up for 6 months after the end of treatment. Results: Both modalities were effective in the treatment of pseudo‐AN; however, the therapeutic response was significantly higher in the fractional CO2 laser group compared to the TCA peel group (p < 0.01). Marked to excellent response (51%–100% clearance of AN lesions) was achieved in 85% of the patients in the fractional laser group versus 10% of the patients in the TCA group. Adverse effects, for example, persistent erythema, post‐inflammatory hyperpigmentation, and burning sensation, were also statistically higher in the TCA group compared to the laser group (p = 0.04). Conclusion: Fractional CO2 laser is a promising effective and well‐tolerated treatment modality for pseudo‐acanthosis nigricans. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and safety of resveratrol combined with ablative fractional CO2 laser system (AFL) treating skin photoaging. Methods: Thirty‐two subjects were assigned to the treatment group (TG) or the control group (CG), respectively, applied test product (resveratrol essence) or control product twice daily for 6 months. Each subject was given an AFL treatment or no laser treatment on left or right side of the face randomly. Subjective evaluations by investigators and subjects themselves were conducted after treatment. Melanin index, erythema index, and cuticle moisture content were conducted at baseline and after treatments. Adverse events (AEs) were evaluated during the study period. Results: All subjects in TG achieved improvements of their photoaging signs compared to pre‐treatment both the laser side and the non‐laser side at 6 months (p < 0.05). On the laser side, TG produced a better improvement than CG at 6 months (p < 0.05). On the laser side, the difference values of MI in TG at the 2 months after enrollment (M2), M3, and M4 were more obvious than those in CG (p < 0.05). On the non‐laser side, the difference values of MI in TG at M3, M4, M5, and M6 were more obvious than those of CG (p < 0.05). Subjects in TG were more likely to have tingling and had a faster subsidence of erythema mild edema, and pigmentation induced by AFL compared to CG. Conclusion: The resveratrol can improve photoaging alone and add an efficacy to the AFL treatment and subside the AEs induced by AFL. [ABSTRACT FROM AUTHOR]

Objective: Severe acute respiratory syndrome coronavirus‐2 spreads through respiratory fluids. We aim to quantify aerosolized particles during laryngology procedures to understand their potential for transmission of infectious aerosol‐based diseases. Study Design: Prospective quantification of aerosol generation. Methods: Airborne particles (0.3–25 μm in diameter) were measured during live‐patient laryngology surgeries using an optical particle counter positioned 60 cm from the oral cavity to the surgeon's left. Measurements taken during the procedures were compared to baseline concentrations recorded immediately before each procedure. Procedures included direct laryngoscopy with general endotracheal anesthesia (GETA), direct laryngoscopy with jet ventilation, and carbon dioxide (CO2) laser use with or without jet ventilation, all utilizing intermittent suction. Results: Greater than 99% of measured particles were 0.3 to 1.0 μm in diameter. Compared to baseline, direct laryngoscopy was associated with a significant 6.71% increase in cumulative particles, primarily 0.3 to 1.0 μm particles (P <.0001). 1.0 to 25 μm particles significantly decreased (P <.001). Jet ventilation was not associated with a significant change in cumulative particles; when analyzing differential particle sizes, only 10 to 25 μm particles exhibited a significant increase compared to baseline (+42.40%, P =.002). Significant increases in cumulative particles were recorded during CO2 laser use (+14.70%, P <.0001), specifically in 0.3 to 2.5 μm particles. Overall, there was no difference when comparing CO2 laser use during jet ventilation versus GETA. Conclusions: CO2 laser use during laryngology surgery is associated with significant increases in airborne particles. Although direct laryngoscopy with GETA is associated with slight increases in particles, jet ventilation overall does not increase particle aerosolization. Level of Evidence: 3 Laryngoscope, 131:2759–2765, 2021 [ABSTRACT FROM AUTHOR]

The routine options for onychomycosis are oral, topical, and device‐based therapies which are often limited in terms of efficacy and unsatisfactory side effects. Topical agents such as luliconazole, tioconazole, terbinafine, and tazarotene can be more effective when combined with laser therapies. Our aim was to compare the efficacy and satisfaction rates of CO2 laser therapy with topical agents in patients with onychomycosis. PubMed, the Cochrane Library, Embase, and Ovid databases were searched to identify randomized controlled trials (RCTs) evaluating the effects of combined therapies. Selected study data were analyzed for differences expressed as odds ratio (OR) and relative ratio (RR) with 95% confidence intervals (CI) for dichotomous outcomes. Efficacy and satisfaction outcomes were assessed using quantitative methods. Our investigations showed that combined CO2 laser and topical treatments significantly increased efficacy 5.38‐fold when compared with topical agents alone (OR 5.38; 95% CI; 3.20–9.04; p < 0.00001), with low heterogeneity observed among studies (I2 = 38%). Mycological clearance comparison rates were also improved by combined treatments. The higher satisfaction of the combined group was assessed by pooled effect (OR 4.56; 95% CI; 2.78–7.49; p < 0.00001). Our evidence suggests combined therapy may exert positive effects and satisfactory safety for patients with moderate to severe onychomycosis, however, optimal combination options and appropriate dosages require more comprehensive RCTs. [ABSTRACT FROM AUTHOR]

Seborrheic keratosis (SK) is a common benign skin epidermal lesion. Different treatment modalities have been proposed for this lesion. This study aimed to compare the efficacy and safety of electrodesiccation, cryotherapy, CO2 laser, and Er:YAG laser in the treatment of SK. The study was carried out on 30 patients each with four similar facial SKs. Each lesion was assigned to be treated with cryotherapy, electrodesiccation, CO2 laser, and Er:YAG laser in a random fashion. Therapeutic results were evaluated 8 weeks after the interventions through clinical and dermatoscopic assessment. Treatment improvement criteria for each lesion included the texture of the lesion, severity of the pigmentation, and an overall assessment of the healing. The severity of burning, pain, erythema, and the duration of the erythema after the procedures were documented. A survey of the patients' satisfaction with the treatments was also performed. In the assessment of overall lesion healing by two dermatologists, the improvement rate was significantly higher in the CO2, Er:YAG lasers and electrodesiccation group compared to the cryotherapy (p < 0.001). However, the CO2 and Er:YAG laser and the electrodesiccation groups showed no significant difference (p > 0.05). Moreover, no significant difference was observed in posttreatment pigmentation and texture between the groups (p > 0.05). The pain and burning severity after the interventions were negligible in all four groups. Prolonged erythema was not observed in any of the cases; however, the duration of erythema in the Er:YAG laser group was significantly longer (p < 0.001). Patient satisfaction in the cryotherapy group was significantly lower than the other three groups (p < 0.001). The efficacy of treatment and patient satisfaction rate is highly comparable between electrodesiccation, CO2 laser, and Er:YAG laser but significantly higher than cryotherapy. [ABSTRACT FROM AUTHOR]

Summary: Laser‐scribed carbonization of polyimide (PI), also known as laser‐induced graphene (LIG), has been used to fabricate flexible and conductive traces on polymer films. With the assistance of electrical tests, scanning electron microscopy (SEM) and Raman spectrometry, a systematic procedure, was used to investigate the effect of laser operating parameters (laser power, scanning speed, and pitch) on the electrical properties, morphology, and thermal performance of the laser scribed carbonized circuits. Identifying the laser optimum operation conditions, flexible heaters with various thermal patterns are produced directly on the PI films and their electro‐thermal performance was evaluated. Although the experimental results indicated anisotropic behavior of the laser‐induced carbonized traces, with regard to in‐plane vs through‐plane conductivity, the optimized heaters demonstrated a rapid response time, reaching equilibrium within less than 60 seconds and being able to achieve temperatures upward of 90°C using relatively low DC voltages of 6 to 24 V. These promising attributes and the demonstrated ability to pattern small features (<100 μm) rapidly and into arbitrary designs make the approach ideal for applications where space and weight are critical factors such as in microfluidics, aerospace, and defense, especially when compared to traditional heaters made from metals which are heavier and more complicated to pattern. [ABSTRACT FROM AUTHOR]

Background: Ablative fractional laser generates a regulated skin damage, which secondarily improves skin aging. Aims: The main objective of the present study was to figure out if the adverse effects induced by laser and the skin recovery could improve with the application of a cosmetic product based on the secretion of Cryptomphalus aspersa (SCA). Patients/Methods: A prospective double‐blind controlled study with vehicle in 10 patients with skin aging. The patients received one session of fractional ablative CO2 laser, and the formulation with SCA 40% was applied immediately and maintained throughout the 21‐day duration of the study. The active treatment (SCA) was applied to one hemifacial area and vehicle to the other, and the patient acting was her own control. Clinical evaluations, dermoscopy, photography, and other parameters like cutaneous hydration, elasticity, and wrinkles were evaluated. In addition, the severity of the adverse effects was evaluated. Results: Significant greater decrease in the density of microcolumns produced by laser was detected on the active‐treated side, indicating greater and faster postprocedure recovery compared to the vehicle‐treated side. In addition, side effects were reduced and some antiaging effects were more apparent on the side treated with SCA 40%. Conclusion: SCA 40% applied immediately after ablative laser, and during the next days, it can accelerate laser‐induced damage regeneration. In addition, SCA improves the cosmetic outcome after laser application. [ABSTRACT FROM AUTHOR]

Actinic keratoses (AK) have been described as either intraepithelial keratinocytic dysplasia that can evolve into invasive squamous cell carcinoma (SCC) or as in situ SCC that can progress into an invasive form. A retrospective study was conducted to compare outcomes of three different topical therapies for patients with single AK (<4): cryotherapy, CO2 laser and 5‐fluorouracil 0.5%/salicylic acid 10%. We included 72 patients who presented at the Dermatology Clinic of Maggiore Hospital of Trieste between 1 November 2019 and 31 January 2020 for the treatment of AKs. All treatments led to a significant reduction in the average diameter of AK. Pain felt by patients was significantly lower after 5‐FU 0.5%/SA 10%. Side effects appeared similarly distributed among the three groups, with erythema and crusts being the most frequent. Aesthetic outcomes were highest in the 5‐FU 5%/SA 10% group, as evaluated by both the patient and the operator. Cryotherapy, CO2 laser and 5‐FU 5%/SA 10% were all effective, with no significant efficacy differences among them. Additionally, 5‐FU 5%/SA 10% was proved to have the best aesthetic result and to cause the least pain, while necessitating long‐term administration. This should be taken into account for patients with low pain tolerance and low treatment adherence. Cryotherapy and CO2 laser have the advantage of requiring a single session, which might be more suitable for uncooperative patients. [ABSTRACT FROM AUTHOR]

Among different laser types, the carbon dioxide (CO2) laser remains one of the most used by dermatologists. Its usefulness has been demonstrated both for therapeutic and cosmetic purposes. This review aims to provide an overview of the applications of CO2 laser in dermatology, focusing on the treatment of infective, neoplastic, and antiaesthetic lesions. [ABSTRACT FROM AUTHOR]

3D multicellular tumor spheroids (MCTSs) have recently emerged as a landmark for cancer research due to their inherent traits that are physiologically relevant to primary tumor microenvironments. A facile approach–laser‐ablated micro U‐wells–has been widely adopted in the past decade. However, the differentiation of microwell uniformities and the construction of arrays have all remained elusive. Herein, an improved laser‐ablated microwell array technique is proposed that can not only achieve arrayed MCTSs with identical sizes but can also perform high‐throughput drug assessments in situ. Three critical laser ablation parameters, including frequency, duty cycle, and pulse number, are investigated to generate microwells flexibly with a range from 170 to 400 μm. The choice of microwells is optimally arranged into an array via precise control of horizontal spacing (dx) and vertical spacing (dy) amenable of cell‐loss‐free culture during cell seeding. Harvested T24, A549 and Huh‐7 MCTSs from the microwell array correspond to approximately 75 to 140 μm in diameter. Anticancer drug screening of cisplatin validated IC50 values in 2D and MCTS conditions are 3.5 versus 9.1 μM (T24), 11.8 versus 277.7 μM (A549) and 33.5 versus 52.8 μM (Huh‐7), and the permeability is measured to range from 0.042 to 0.58 μm min−1. [ABSTRACT FROM AUTHOR]

Keywords: Venous malformations; vascular anomalies; Nd:YAG laser; bleomycin sclerotherapy; CO2 laser; airway EN Venous malformations vascular anomalies Nd:YAG laser bleomycin sclerotherapy CO2 laser airway E521 E524 4 01/15/21 20210201 NES 210201 INTRODUCTION Venous malformations (VMs) are classified as low-flow vascular lesions composed of abnormal venules present at birth, yet may not be clinically apparent until adulthood.1,2 VMs enlarge passively throughout life through hydrostatic forces and recruitment of collateral venules.3,4 Symptoms may arise secondary to enlargement or phlebolith formation.2-4 Clinically, VMs are soft, compressible, and have a violaceous appearance.3-6 Reversible expansion of the VM can be provoked by dependent position or Valsalva maneuvers.6,7 Up to 40% of VMs occur in the head and neck region, frequently affecting the airway.8 VMs affecting the airway present unique diagnostic and treatment challenges. MATERIALS AND METHODS A brief retrospective review was conducted of patients undergoing multimodal treatment of upper airway VMs using Nd:YAG laser bleomycin sclerotherapy by the senior authors (m.w. and t.m.-j.o.), For patients with redundant supraglottic tissue after sclerotherapy and Nd:YAG treatments, a defocused beam of CO SB 2 sb laser at 3 to 5 W was used to ablate the surplus mucosa under microscopic guidance. (F) Final appearance of the airway of the same patient prior to decannulation 7 months following the start of treatment. gl Patient was brought to the operating room (OR) for an awake tracheotomy and initial treatment with a Nd:YAG laser. [Extracted from the article]

Background: Condyloma acuminatum (CA) is both highly infectious and frequently recurring and requires long‐term, repeated treatments, which seriously affect the physical and psychological health of patients. The purpose of the present study was to investigate the effectiveness of a combination therapy of traditional Chinese medicine and CO2 laser on CA and the relationship between CA relapse and cellular immunity. Methods: The study cohort consisted of 160 CA patients who underwent ambulatory treatment between January 2017 and January 2019 in the Department of Dermatology and Venerology of our hospital. The 160 patients were randomly divided into two groups: a combination therapy group (80 cases), who underwent CO2‐laser treatment followed by three courses of oral traditional Chinese medicine and a control group (80 cases), who were only treated with the CO2 laser to remove warts. The efficacy of the CO2‐laser treatment was evaluated on the first month after treatment and relapse was evaluated at monthly follow‐ups for 6 months. Additionally, 20 normal volunteers were also recruited. Three months before and after treatment, the cellular immunity factors of peripheral blood T lymphocyte subsets, including CD4+, CD8+, CD4+/CD8+, and interleukin‐2 (IL‐2), were detected and compared between CA patients and normal volunteers, the combination therapy and control groups, and the relapse and cure groups to determine whether there were statistical differences. Results: Compared with normal volunteers, CA patients exhibited lower CD4+, CD4+/CD8+, and IL‐2 levels and higher CD8+ levels (P <.05). In addition, the rates of relapse for the combination therapy and control groups were 25.7% and 40.8%, respectively. However, the comprehensive immunity factors showed no statistical difference (P >.05) before treatment. Three months after treatment, factors including CD4+ and CD4+/CD8+ were higher in the combination therapy group than in the control group (P <.05), and CD8+ and IL‐2 showed no statistical difference (P >.05); factors including CD4+, CD4+/CD8+, and IL‐2 were higher and CD8+ was lower in the cure group than in the relapse group (P <.05). Conclusion: The therapy combination of traditional Chinese medicine and CO2‐laser treatment can reduce the relapse rate of CA. It might be that traditional Chinese medicine combined with CO2‐laser treatment regulate liver meridian, Qi and blood, and restore the balance between various subgroups. Highlights: The therapy combination of traditional Chinese medicine and CO2‐laser treatment can reduce the relapse rate of CA. It might be traditional Chinese medicine combined with CO2‐laser treatment regulate liver meridian, Qi and blood. [ABSTRACT FROM AUTHOR]

Erbium: Yttrium‐aluminum‐garnet laser (Er: YAG) treatment has been used in resurfacing the acne scars for a long time; however, we could not find any study reporting the recovery rates after each session of the treatment. In this study, we aimed to report the improvement rates after each session. We retrospectively analyzed the data of 35 patients with acne scars treated with fractional ablative Er: YAG laser. The patients received one to four sessions of treatment with 4‐week intervals and improvement rates were recorded after each session. Data are available on request from the authors. The improvement rate of the lesions varied between 1% and 25% in 34 patients at the end of the first session, while in one patient, the improvement rate was detected as 26% to 50%. At the end of the fourth session, the rate of improvement was 26% to 50% in 14 out of 24 patients and 51% to 75% in 10 patients. None of the patients showed a 76% to 100% improvement at the end of the fourth session, whereas 48.6% of the patients were satisfied with the treatment. In patients with a high expectation of an excellent improvement, a higher number of sessions of the laser treatment and/or combination treatments with different treatment methods should be planned. [ABSTRACT FROM AUTHOR]

Surgical treatment of vitiligo lesions over the fingers has poor outcome. In this intra‐patient comparative study, 12 patients with stable non‐segmental vitiligo (NSV) affecting the middle three fingers of one hand were included. Three variations were used in treatment of finger vitiligo lesions: minipuch grafting, melanocytes keratinocyte transplantation procedure (MKTP) preceded by cryoblebbing or full CO2 laser resurfacing of the recipient site. Liquid nitrogen was used to create blebs in one finger 24 hours before therapy. On the following day, the second finger was treated by minipunch grafting and the third finger was resurfaced by CO2 laser. A suspension was prepared and 0.1 mL was injected into each cryobleb. It was also applied to the resurfaced skin. All patients underwent topical PUVA therapy and were followed‐up for 12 months. Ten cases with 52 lesions completed the follow‐up period. About 4/18 lesions treated by cryoblebbing followed by MKTP showed ≥75% repigmentation while only 1/17 lesions treated by laser resurfacing + MKTP and 1/17 lesions treated by minipunch grafting showed 30% and 10% repigmentation, respectively. No complications occurred in MKTP treated lesions. Cryoblebbing of the recipient site seems to improve the outcome of MKTP in lesions over the fingers in stable NSV. [ABSTRACT FROM AUTHOR]

Keloids and hypertrophic scars could impair the psychological, physical, and cosmetic aspects of the patient's quality of life. Unfortunately, there is no curative treatment available till now. This study aimed to evaluate the efficacy and safety of intralesional vs topical botulinum toxin A combined with Fractional CO2 laser in the treatment of hypertrophic scars and keloids. Twenty patients with Keloids and hypertrophic scars were enrolled in the study. Each scar was divided into two halves, one subjected to intralesional injection of botulinum toxin type A once a month for 4 months and the other was subjected to four sessions of CO2 laser therapy at 1 month interval followed by topical application of botulinum toxin A. Significant improvement was noted in Vancouver Scar Scale in hypertrophic scars in laser group than intralesional botulinum toxin A. In keloid cases, the improvement was significantly higher with intralesional botulinum toxin A. Clinical improvement showed significant negative correlation with scar duration and size. Botulinum toxin A is a promising treatment for hypertrophic scars and keloids. The use of fractional CO2 laser as a mode of delivery enhanced the efficacy of botox in hypertrophic scars. [ABSTRACT FROM AUTHOR]

Background: A wide variety of minimally invasive treatments are available for skin aging. Recently, carbon dioxide therapy (CDT) or carboxytherapy was used in many cosmetic indications including facial rejuvenation. Objective: To compare the efficacy of CDT alone versus combined CDT and fractional CO2 laser in management of facial aging. Methods: Twenty‐Five female patients with bilateral and symmetrical facial aging were included in the study. The right (Rt) hemiface received 8 sessions of CDT whereas the left (Lt) side was treated with combined technique (6 sessions of CDT and 2 sessions of fractional CO2 in between. Clinical and objective evaluation using 3D skin analysis, histological, and morphometric analysis were performed. Results: Clinical evaluation demonstrated that all patients (100%) were satisfied with no significant difference between both sides of the face (P >.05). Regarding texture and pigmentation improvement, the Lt side (combined) showed significant improvement compared to the Rt side (P <.05). Using Antera 3D camera, there was a significant difference (P <.05) in 3D improvement percent in textural changes while there was no significant difference (P >.05) in the 3D percent of wrinkles improvement between both sides. The Lt side showed more significant increase in epidermal thickness after treatment when compared to the Rt side (P <.05) with evident neocollagen formation. Conclusion: Carboxytherapy is an easy, safe, simple, and a relatively effective method for facial rejuvenation with minimal downtime. Better results were achieved when used in combination with fractional CO2 laser. [ABSTRACT FROM AUTHOR]

Background: Cutaneous leishmaniasis (CL) is an endemic disease of Iran and despite self‐healing nature of this disease and many suggested treatments, scar is usually inevitable results of the affection with this cutaneous infection. CO2 laser in CL has a specific thermolysis effect on infected tissues and application of trichloroacetic acid (TCA) 50% solution for treatment of leishmaniasis scars showed promising results. Aim: To evaluate CO2 laser plus TCA 50% versus CO2 laser alone for treatment of CL. Patients/Methods: In the current report, we present 6 cases of noduloulcerative CL that were treated successfully by the combination of the continuous wave CO2 laser plus topical application of TCA 50%. Results: Five patients improved after 3 weeks of starting treatment, and 1 patient needed to repeat treatment. The scars were flat and good. Conclusions: The CO2 laser plus topical TCA 50% may be more effective in treatment of the cutaneous leishmaniasis and results in shorter healing time. [ABSTRACT FROM AUTHOR]

Objective: Patients with laryngeal pathology are often treated with CO2 laser surgery, usually in the operating room under general anesthesia. Although office-based laser surgery using several other laser types has been investigated, prospective studies on office-based CO2 laser surgery are scarce. Our goal was to investigate the feasibility of office-based CO2 laser surgery for benign and premalignant laryngeal pathology by analyzing completion rate, safety, effect on voice quality, and success rate (i.e., no residual or recurrent disease).Methods: A prospective cohort study was performed of 30 consecutive procedures. Inclusion started in June 2016 and was completed in August 2018. Adult patients with clinically benign or premalignant laryngeal lesions who could not undergo transoral laser microsurgery in the operating room under general anesthesia were included. Reasons were either contraindications for general anesthesia, previously failed therapeutic laryngoscopy under general anesthesia, and preference of a procedure under topical anesthesia by the patient. The mean follow-up was 9 months.Results: Thirty procedures were performed in 27 patients (24 males) with an average age of 62 years. Twenty-nine (97%) procedures were fully completed without complications. The mean preoperative Voice Handicap Index (VHI) score (VHI 44) significantly decreased 2 months (VHI 28, P = 0.032) and 6 months (VHI 14, P < 0.001) after the procedure. Almost two-thirds of patients showed no residual or recurrent disease at their follow-up visits.Conclusion: Office-based CO2 laser surgery is a feasible and safe procedure that results in significant voice-quality improvement. Almost two-thirds of patients did not require further treatment.Level Of Evidence: 2 Laryngoscope, 130:1503-1507, 2020. [ABSTRACT FROM AUTHOR]

Background: Numerous treatment modalities for keratosis pilaris have been tried with limited success. Aim: To determine the efficacy, safety, and tolerability of fractional CO2 laser in the treatment of KP. Patients and methods: This prospective, single‐blinded split‐body placebo‐controlled comparative study was conducted on 60 patients with bilateral KP of arms (group A) and thighs (group B). One side randomly received fractional CO2 laser treatment (power 12 W, time on 3 ms, PPI 5) in the form of two sessions four weeks apart. The contralateral control side was treated with a topical keratolytic (10% urea). Standardized digital clinical and dermoscopic photographs were obtained at each visit. Results: Significant improvement has been demonstrated clinically and dermoscopically in both arm and thigh lesions after fractional CO2 laser. In group A, excellent improvement was noted in 10 patients (33.3%), good improvement in 18 patients (60%), and moderate improvement in 2 patients (6.7%) at the second visit. In group B, minimal improvement was noted in 2 (6.7%) patients, moderate improvement in 16 patients (53.3%), and good improvement in 12 patients (40%) at the second. Control sides showed minimal improvement on the arm lesions only. No side effects were reported in both groups. The mean pain score in group A was not significantly different from that group B (P =.057). Patient satisfaction was significantly higher in the laser‐treated side arm lesions (P <.001). Conclusion: Fractional CO2 laser was associated with significant clinical and dermoscopic improvement of keratosis pilaris lesions in Egyptian patients. [ABSTRACT FROM AUTHOR]

Addition of different growth factors to the medium used in autologous melanocyte‐keratinocyte transplantation procedure (MKTP) was reported in the literature. The aim of the current study was comparison of response to MKTP in segmental vitiligo (SV) with and without adding growth factors to the suspension medium. Eighteen cases with SV were randomly divided into two groups. In group A: Ham F12 medium was used for suspension and in group B: 5 ng/mL recombinant basic fibroblast growth factor (bFGF) and 25 mg/500 mL 3′5′ cyclic adenosine monophosphate (cAMP) were added to the medium. All cases received NB‐UVB twice weekly for 24 weeks. The area of vitiligo lesions was measured before and after therapy by point‐counting technique and complications were recorded. Excellent response (90%‐100% repigmentation) occurred in 5/9 cases (56%) in group A and 7/9 cases (78%) in group B (with growth factors). A significant decrease in the area of treated lesions before and after therapy was found in both groups A and B (P =.0012 and.0004, respectively), however, a higher percentage of reduction in area of vitiligo was seen in group B cases (70% in group A vs 90% in group B; P value:.028). Marginal halo was seen in five cases in group A and six in group B. In conclusion addition of bFGF and cAMP to MKTP medium improved the results of the procedure. It could be considered if economically feasible. [ABSTRACT FROM AUTHOR]

We report on a 73‐year‐old male patient with granulomatosis with polyangiitis (Wegener's granulomatosis) who developed increasingly growing lesions of actinic keratosis (AK) and squamous cell carcinoma (SCC) of the scalp under systemic immunomodulatory therapy with azathioprine for more than 8 years. The patient underwent a first‐line surgical therapy resulting in histologically confirmed R0 resection status followed by topical imiquimod treatment and cryotherapy. However, recurrence of AK/SCC progression could not be stopped sufficiently. Therefore, due to the difficult localization of the lesions at the head and the limitation of further surgical procedures, the patient was presented to our laser medicine department in order to consider complementary therapy options. The therapy approach was combining photodynamic therapy (PDT) with laser‐assisted drug delivery (LADD). PDT has been successful in treating field cancerization for decades, but it has limitations in the treatment of hyperkeratotic lesions. Pre‐treatment with LADD can be used to optimize the penetration depth of the prodrug 5‐aminolevulinic acid (BF‐200 ALA, Ameluz) and significantly increase the bioavailability as well as inducing an inflammatoric reaction. Following this therapeutic approach, we were able to achieve a stable disease over a follow‐up period of 2 years after six sessions of combined LADD + PDT. [ABSTRACT FROM AUTHOR]

A novel approach for en bloc resection of a limbal melanoma using a CO2 laser in a dog. Benefits of this advanced technique include excellent surgical precision, improved hemostasis, and the induction of coagulative necrosis of neoplastic cells. [ABSTRACT FROM AUTHOR]

This in vitro study aimed to analyze the physical and chemical characteristics of the hypersensitive human dentin‐like surface after application of a bioactive glass (BG) paste (BG/Ac) irradiated or not with high‐power lasers. Dentin specimens were treated with 17% Ethylenediamine tetraacetic acid (EDTA) solution to mimic a hypersensitive dentin and then submitted to neodymium: yttrium–aluminum–garnet (Nd:YAG) laser or CO2 laser irradiation prior and after application of BG/Ac. Characterizations were performed by using X‐ray diffraction, Fourier transformed infrared spectroscopy, scanning electron microscopy, and energy dispersive X‐ray spectroscopy. The results suggested that application of BG/Ac by itself caused some obstructions of dentinal tubules. Nd:YAG laser irradiation reduced the opening of the dentinal tubules with no changes in the collagen structure. CO2 laser irradiation caused dentin melting and resolidification along with cracks and chemical changes in collagen fibers. However, when BG/Ac paste was irradiated with lasers, a sequence of surface reactions between glass and dentin interface led to the formation of an amorphous hydroxyapatite layer, similar to that of an inorganic component of the normal dentin. Moreover, BG/Ac was able to prevent the formation of cracks and degradation of collagen fibers caused by CO2 irradiation. Overall, this study supports that application of BG/Ac paste irradiated by high‐power laser could represent an effective and long‐lasting therapeutic approach for dentin hypersensitivity. [ABSTRACT FROM AUTHOR]