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The authors have reviewed researches on laser palate surgery and stages of its historical development for providing surgical care to patients with ronchopathy and the obstructive sleep apnea syndrome. They also assessed the effectiveness of traditional techniques for uvulopalatoplasty as well as the effectiveness of laser light application in uvulopalatoplasty and its modifications.

Despite of an obvious success in the management of cancer patients and in the quality of medical care for them, however there are still open questions on the effectiveness of prevention and treatment of complications after surgery, chemotherapy, and radiotherapy, as well as on the quality of comprehensive rehabilitation of such patients. One of the possible ways to solve these issues is low-level laser therapy.Laser therapy in Russia has been successfully used in many areas of modern clinical medicine for more than 50 years; it is still developing and improving. Main advantages of laser therapy are simplicity, comfort, and safety for patients, as well as low costs.The widespread use of low-level laser light has experimental and clinical justification. Awareness in principles of dosing, methodological features of laser procedures, justified prescription and strict compliance with indications and contraindications can ensure high effectiveness of the discussed therapy in oncologic patients.

Purpose: to evaluate the effectiveness of low-level laser radiation in the complex rehabilitation of patients with head and neck tumors after radical surgical treatment as well as to assess the influence of the discussed treatment on the quality of their life.Material and methods. 134 patients with head and neck cancer aged 23–78 years (mean age – 54.24 ± 12.7 years ) were taken into the study. There were 39 (29.1 %) men and 95 (70.9 %) women. All patients were divided into three groups. In Group 1 (n = 45), patients received traditional rehabilitation treatment (physical exercises, massage, medication); in Group 2 (n = 45), patients had a course of traditional rehabilitation plus low-level laser therapy (LLLT); in Group 3 (n = 44), patients had only several LLLT courses as rehabilitation therapy. For laser therapy, laser device “Azor 2K-02” (laser hazard of class II, GOST 12.1.040-83) was used.Results. During the treatment, most of the patients noted early disappearance or noticeable decrease in pain and numbness intensity at the site of the surgical; skin sensitivity and increase of the muscular tone in the shoulder girdle and upper limb at the site of the surgical were restored as well. The most pronounced regression of complaints after rehabilitation therapy was observed in patients who had LLLT in combination with other rehabilitative measures.Conclusion. Radical surgical or combined treatment of patients with malignant tumors of head and neck causes functional disorders of tissues and organs at the site of treatment. Rehabilitation therapy with LLLT in red and/or infrared spectrum range ensures adequate restoration of impaired functions what improves the quality of life of such patients.

Purpose: to study the effect of low-level laser therapy (LLLT) in correction of blood hemodynamic and rheological parameters after surgery for head and neck cancer.Material and Methods. The study included 134 head and neck cancer patients with a median age of 54.24 ± 12.7 years (range: 23–78 years). There were 39 (29.1 %) men and 95 (70.9 %) women. To assess the effectiveness of LLLT, all patients were divided into 3 groups. Group I included 45 patients, who received conventional therapy without the use of LLLT. Group II consisted of 45 patients, who received conventional therapy in combination with LLLT. Group III included 44 patients, who received LLLT alone. Azor 2K-02 was used as a source of LLLT in the red to near infrared spectral range. Characteristics of blood flow in the vessels of the neck and the rheological properties of blood, as well as the parameters of spontaneous platelet aggregation and the content of soluble fibrinmonomer complexes in the blood plasma of patients were studied.Results. The data obtained indicated that the use of LLLT promoted normalization of blood rheological properties in patients, who underwent surgery. Normalization of blood rheological properties occurred faster and lasted for a longer period. In patients, who received conventional therapy in combination with LLLT, the hemodynamic and rheological parameters of blood were improved 2–14 days after therapy, whereas in patients receiving conventional therapy alone, this improvement was seen 30 or more days after therapy.Conclusion. LLLT in combination with conventional therapy was shown to have a positive effect on hemodynamic and rheological parameters after surgery for head and neck cancer.

Biomedical studies for identifying response parameters of biological objects correlated with phototherapeutic effects are discussed. Investigations were performed during phototherapeutic treatment of patients with post-mast-ectomy syndrome who underwent surgical removal of a mammary gland affected by cancer. Matrix LED emitters with wavelengths from 660 to 860 nm were used. To determine the correlated response parameters, a two-channel digital thermometer and a two-channel photoplethysmograph were used. Both amplitude of the pulse curve and temperature of the surface tissues can serve as correlated response parameters. By monitoring these parameters, feedback systems can be created that enable individual dose setting of optical exposure for an individual phototherapeutic procedure, as well as for the whole course of treatment.

A new combined photoultrasonic technique is suggested for the treatment of infectious injuries. The experiments were implemented on 70 male chinchilla rabbits (7 groups). The dynamics and nature of injuries' healing were analyzed by clinical pathomorphological and histochemical data as well as by biopsy samplings and capillaroscopy of injuries' edges. The experimental results of animals' models demonstrated a high efficiency of the combined photoultrasonic treatment as applicable to the above injuries.

The calculation data are presented on a critical temperature area (45-60 deg. C) located in the wall of the gastrointestinal tract, following exposure to continuous laser radiation (1.06(m). Positive clinical results were reported on the use of the fiber-type modification of the continuous 250W YAG:ND laser in the treatment of 217 patients with benign, malignant tumors and cicatricial strictures in the lumen of the gastrointestinal tract, trachea or bronchus.

The further development of new method of phototherapy based on use of light-emitting diodes (LED) arrays has been presented. LEDs array distribution is side of cylindrical surface, covering pathology region, was used for treatment group of patients with an affected peripheral nervous system. The main group consisted of patients with humeral plexopathy - one of possible neurological manifestation of postmastectomic syndrome as result of breast cancer radical treatment. This disease was accompanied also by some other peripheral nervous system diseases: diabetic polyneuropathy, compression ischemic mononeuropathy, festering wounds and others. The phototherapeutic method is just directed on improvement of patient's conditions in combination with other traditional methods of treatment. The main parameters of photomatrix therapeutic system: wavelength - 660 nm, line width - no more than 20 nm, intensity of radiation on the surface of edema - 0.5-3 mW/cm2 (in dependence of apparatuses type). To control and study efficiency of phototreatment ultrasonic dopplerography, thermography, electromyography and viscosimetry have been used.© (2001) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

A new combined photoultrasonic (CPUS) technology for the treatment of infected wounds is suggested. The CPUS principal operation is based on the topical application of a photosensitizer followed by light irradiation in combination with low frequency ultrasonic (US) treatment of wounds. In CPUS, two methods - photodynamic (PDT) and ultrasonic therapies supplement each other beneficially and in conjunction provide a significant effect of deep suppurative inflammatory wounds treatment. The main advantages of the new technology are the combined application of an antibiotic solution and photodynamic therapy to destroy antibiotic- resistant microorganisms, an effective mixing of a photosensitizer in the wound, the US enhancement of photosensitizer impregnation into the membranes of bacteria, the US clearing of wound surface from necrotic products, an increased effective light dose exposure in the whole volume of the deep wound when the light does not penetrate totally inside the wound, an additional bactericidal effect under the US impact, and the combined effect of CPUS activation of the immune system.

One of the possible consequences of mastectomy is lymphedema of soft tissues of upper extremities on the side ofablated breast as result of cutting and trauma of multiple nerves, lymphatic and blood vessels. This phenomenon is oftenaccompanied by deterioration of blood and lymphatic microcirculation, increasing of stagnation and aggregation ability ofthrombocities, limitation ofhumeral and ulnarjoint activity, severe pain and decreasing of myotonus.The developing of new phototherapeutic method based on using of light-emitting diodes (LED) arrays is attempted.This method is just directed on improvement of patient's condition in combination with other traditional methods such asdrug therapy, pressure bandaging etc. The main parameters of LED arrays fixed inside cylindrical tube covering pathologyregion are: wavelength — 660 nm, intensity range — 0.5 mWI sm2. To control and study efficiency of phototreatmentultrasonic dopplerography, thermography, electromyography and viscosimetry have been used.During clinical trials in oncology department of Moscow State University of Medicine and Dentistry 128 patientshave been treated with following results: patients felt complete disappearance of pain and weightiness sensation in arm,restoration of skin sensitivity and muscle strength. There were statistically proved amelioration of excitation spreadingvelocity on radial nerve, decreasing of blood viscosity, increasing of blood velocity in main arteries of shoulder andsymmetry oftemperature distribution.Keywords: phototherapy, LED array, breast cancer, mastectomy, postmastectomic complications, lymphedema.

This review reflect the latest achievements of Russian science in the field of creating laser and phototherapeutic combined technologies for oncology. This article tackles the problem of further developing laser-ultrasonic medical technologies and its applications in oncology. The comparison and the features of alternative sources for photodynamic therapy including the lasers, the lamps with spectral filters and LED array are considered. The application photomatrix system for treatment posmastectomy oedema are presented. The possibilities of laser transcutaneous photosensitizer delivery methods are discussed.

The oncological substantiation of endoscopic and economical surgical treatment of T1N0-1M0 gastric carcinoma in 46 patients was appraised. The results were studied with due regard for the peculiarities of early gastric carcinoma (EGC) revealed in 290 patients after standard surgical management. It was established that organ-preserving treatment of ECG is possible--5-years survival was 96.2%. Endoscopic removal can be considered radical only in T1P1 tumors without invasion of the lymphatic vessels of the wall and was of a multistage character in 86.2% of cases. Careful surveillance after its completion is necessary. Surgical treatment in indicated in repeated recurrences; they were encountered in 44.8% of cases. The causes of the recurrences were noncoincidence of the macroscopic and histological boundaries of the tumor (33.6%), multicentric growth (30.4%), and invasion of the submucosa. Metastases are encountered in the lymph nodes in 9.1% of cases in economical treatment. In T1N0-1M0P1-2 carcinoma, absence of multicentric growth, and III degree dysplasia in the surrounding mucosa (reflecting increased risk of multicentric growth) the volume of organ resection may be limited on condition that P1 lymphadenectomy is performed. The results of organ-preserving treatment are comparable with those of surgical treatment conducted in a standard volume.

The clinical use of a fiber-laser device based on continuous 250-W YAG-Nd laser allows the pathological tissue to be treated by exposure in various energy regimens, from its coagulation to intensive evaporation; the conditions of treatment created in this case for the patient are more comfortable than those with the use of less powerful laser devices. The elaboration and manufacturing of a new design for guiding the beam into a fiber wave guide with a light-guiding lead of 600 and more microns in accordance with the model of the used endoscope even without gas injection ensures reliable functioning of the fiber-laser device. Overheating of the in put and out put ends of the fiber wave guide in exploitation at large power regimens is excluded despite soiling of the distal end of the wave guide which is inevitable during the operation.

Experiments on operative tissues of the small and large intestine showed that energy density of the order of 1,000 J/cm2 was necessary for heating the biological tissue to yield crater formation. A laser method was developed for forming a canal in the neoplastic tissue obstructing the digestive tract.