DOI:

10.37988/1811-153X_2024_1_84

Thulium laser safe mode selection for in vitro sialolithotripsy

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Authors

  • D.V. Zhuchkova 1, 2, assistant at the Oral and maxillofacial surgery Department; dental surgeon
    ORCID ID: 0000-0002-9200-4257
  • S.P. Sysolyatin 1, 2, 3, PhD in Medical Sciences, full professor of the Dentistry diseases propaedeutics Department; maxillofacial surgeon; full professor of the Dentistry Department
    ORCID ID: 0000-0002-5794-9087
  • 1 RUDN University, 117198, Moscow, Russia
  • 2 “Endostom” Clinic, 125252, Moscow, Russia
  • 3 Medical and Biological University of the State Medical Center named after A.I. Burnazyan, 123098, Moscow, Russia

Abstract

Endoscopic removal of sialoliths larger than 5 mm is possible only in combination with the method of sialolithotripsy. Currently, laser crushing is recognized as the most effective method of endoscopic sialolithotripsy, while the method has a number of serious drawbacks, including the effect of retropulsion of fragments, a long crushing time, the risk of tissue burns, etc. In recent years, the popularity of thulium lasers in urological lithotripsy has been growing, which, according to a number of experts, are superior to other types of devices. It is likely that the thulium laser can also be used for sialolithotripsy, which prompted us to conduct this experimental study. Aim — to evaluate the safety and time of crushing of sialoliths with a thulium laser FiberLase U2 in vitro.
Materials and methods.
The study was carried out in 2 stages using a FiberLase U2 thulium laser in Popcorning, Dusting and Fragmentation modes. For each stage, 12 sialoliths of equal diameter were selected and 2 experimental models were created in which the concretions were crushed alternately. With the help of the first installation, the effect of retropulsion was evaluated, with the help of the second model and a thermocouple, the temperature change during irrigation and the time required for crushing the concretion to particles of size ≤1 mm were investigated. Results: Fragmenting sialoliths to pieces of the required size is a success in all three modes. At the maximum values of the pulse, the crushing process occurred much faster and ranged from 7 to 10 minutes, while accompanied by an increase in the temperature of the irrigation solution to 48°C. Crushing at the minimum values of the laser pulse was characterized by a lower temperature rise in all three modes, however, it took much longer and in the Popcorning mode was 57 minutes.
Conclusion.
It was possible to crush the sialoliths to the required size in all three modes. According to the study, Dusting and Popcorning were safe and effective modes. An experimental study has shown that it is possible to conduct the next stage — research in a clinical setting.

Key words:

sialoliths, lithotripsy, salivary stone disease, fragmentation of sialoliths, sialoendoscopy, sialolithiasis, sialoadenitis

For Citation

[1]
Zhuchkova D.V., Sysolyatin S.P. Thulium laser safe mode selection for in vitro sialolithotripsy. Clinical Dentistry (Russia).  2024; 27 (1): 84—89. DOI: 10.37988/1811-153X_2024_1_84

References

  1. Marchal F., Dulguerov P. Sialolithiasis management: the state of the art. Arch Otolaryngol Head Neck Surg. 2003; 129 (9): 951—6. PMID: 12975267
  2. Phillips J., Withrow K. Outcomes of holmium laser-assisted lithotripsy with sialendoscopy in treatment of sialolithiasis. Otolaryngol Head Neck Surg. 2014; 150 (6): 962—7. PMID: 24598407
  3. Bannikova K.A., Bosykh Yu.Yu., Gaitova V.G., Sysolyatin P.G., Sysolyatin S.P. Indications for the use of sialoendoscopy in sialolithiasis. Modern Technologies in Medicine. 2020; 3: 41—46 (In Russian). eLIBRARY ID: 43820364
  4. Galdermans M., Gemels B. Success rate and complications of sialendoscopy and sialolithotripsy in patients with parotid sialolithiasis: a systematic review. Oral Maxillofac Surg. 2020; 24 (2): 145—150. PMID: 32162129
  5. Koch M., Zenk J., Iro H. Algorithms for treatment of salivary gland obstructions. Otolaryngol Clin North Am. 2009; 42 (6): 1173—92, Table of Contents. PMID: 19962014
  6. Kałużny J., Klimza H., Tokarski M., Piersiala K., Witkiewicz J., Katulska K., Wierzbicka M. The holmium:YAG laser lithotripsy-a non-invasive tool for removal of midsize stones of major salivary glands. Lasers Med Sci. 2022; 37 (1): 163—169. PMID: 33219871
  7. Rai V., Walvekar R.R., Verma J., Monga U., Rai D., Munjal M. Laser-assisted sialolithotripsy: A correlation of objective and subjective outcomes. Laryngoscope. 2022; 132 (12): 2344—2349. PMID: 35289948
  8. Sionis S., Caria R.A., Trucas M., Brennan P.A., Puxeddu R. Sialoendoscopy with and without holmium:YAG laser-assisted lithotripsy in the management of obstructive sialadenitis of major salivary glands. Br J Oral Maxillofac Surg. 2014; 52 (1): 58—62. PMID: 24280118
  9. Filimonov V.B., Vasin R.V., Sobennikov I.S., Shirobakina E.Yu. Comparative analysis of various surgical methods of urolithiasis treatment. Experimental and Clinical Urology. 2022; 3: 88—93 (In Russian). eLIBRARY ID: 49546468
  10. Keller E.X., De Coninck V., Doizi S., Daudon M., Traxer O. Thulium fiber laser: ready to dust all urinary stone composition types? — World J Urol. 2021; 39 (6): 1693—1698. PMID: 32363450
  11. Blackmon R.L., Irby P.B., Fried N.M. Comparison of holmium:YAG and thulium fiber laser lithotripsy: ablation thresholds, ablation rates, and retropulsion effects. J Biomed Opt. 2011; 16 (7): 071403. PMID: 21806249
  12. Hardy L.A., Wilson C.R., Irby P.B., Fried N.M. Thulium fiber laser lithotripsy in an in vitro ureter model. J Biomed Opt. 2014; 19 (12): 128001. PMID: 25518001
  13. Popov S.V., Orlov I.N., Sytnik D.A., Suleimanov M.M., Pazin I.S., Grin E.A., Pestriakov I.Yu. Thulium and holmium ureterolithotripsy: evaluation of thermal effects on the ureter by measuring the temperature of the irrigation fluid in vitro. Experimental and Clinical Urology. 2021; 1: 26—30 (In Russian). eLIBRARY ID: 44895359
  14. Ulvik Ø., Æsøy M.S., Juliebø-Jones P., Gjengstø P., Beisland C. Thulium fibre laser versus holmium:YAG for ureteroscopic lithotripsy: outcomes from a prospective randomised clinical trial. Eur Urol. 2022; 82 (1): 73—79. PMID: 35300888
  15. Becker B., Gross A.J., Netsch C. Ho: YaG laser lithotripsy: recent innovations. Curr Opin Urol. 2019; 29 (2): 103—107. PMID: 30407221
  16. Koch M., Hung S.H., Su C.H., Lee K.S., Iro H., Mantsopoulos K. Intraductal lithotripsy in sialolithiasis with two different Ho:YAG lasers: presetting parameters, effectiveness, success rates. Eur Rev Med Pharmacol Sci. 2019; 23 (13): 5548—5557. PMID: 31298306
  17. Durbec M., Dinkel E., Vigier S., Disant F., Marchal F., Faure F. Thulium-YAG laser sialendoscopy for parotid and submandibular sialolithiasis. Lasers Surg Med. 2012; 44 (10): 783—6. PMID: 23224989
  18. Schrötzlmair F., Müller M., Pongratz T., Eder M., Johnson T., Vogeser M., von Holzschuher V., Zengel P., Sroka R. Laser lithotripsy of salivary stones: Correlation with physical and radiological parameters. Lasers Surg Med. 2015; 47 (4): 342—9. PMID: 25788338
  19. Bazyk-Novikova V.M. Temperature effect of high-intensity laser radiation on a parenchyma of parotid gland in an experiment. Sovremennaya stomatologiya (Belarus). 2017; 3 (68): 60—64 (In Russian). eLIBRARY ID: 30457740
  20. Minaev V.P., Zhilin K.M. Modern laser devices for surgery and power therapy based on semiconductor and fiber lasers. Recommendations for selection and application. Moscow: Balabanov, 2009. 48 p. (In Russian).

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Received

September 19, 2023

Accepted

January 4, 2024

Published on

March 21, 2024