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PubMed1999

[Controlled cosmetic dermal ablation in the facial region with the erbium:YAG laser].

The erbium: YAG laser (wavelength 2940 nm; pulse duration 0.350 ms; pulse energy 0.1-1.7 J) allows vaporization of very thin skin layers without scarring and minimal lateral thermal injury due to an extremely short pulse duration. It permits exact ablation of relatively large areas of facial skin. We report our results with 216 patients following treatment for different facial lesions (facial wrinkles, acne scars, syringomas, and circumscribed sebaceous gland hyperplasia) using a new erbium: YAG laser system. Good-to-excellent cosmetic results were obtained in these patients. Our findings show that the erbium: YAG laser is an elegant and promising new method for the treatment of facial lesions.

Cicatrix↗

PubMed2004

The gold standard for decortication of rhinophyma: combined erbium-YAG/CO2 laser.

Rhinophyma is a benign condition of the nose that often is severely disfiguring and occasionally causes functional problems. A considerable proportion of the patients, with rhinophyma are elderly with chronic medical problems. Electrocautery, heated scalpel, carbon dioxide (CO(2)) laser, argon laser, Weck blade, dermabrasion, cryotherapy, radiotherapy, full-thickness excision, skin graft, flap reconstruction, and cold scalpel have been used either alone or in combination. All these techniques have disadvantages that are resolved by using the combined erbium:yttrium-aluminum-garnet (YAG)/CO(2) laser. The authors present their technique and the results from decortication of rhinophyma using a combined erbium:YAG/CO(2) laser. The technique requires only local anesthesia with a vasoconstrictor. The combination of an efficient vaporization tool consisting of the erbium:YAG laser and the CO(2) coagulation laser provides a nearly bloodless field for accurate sculpting of the nose and produces cosmetically pleasing results.

Carbon Dioxide↗

PubMed1999

Erbium filtration: a cost-effective, dose-reducing filter which maintains abdominal image quality.

The current study investigated the effect of erbium filtration on an anteroposterior abdominal image. The radiation dose reductions achievable and the cost effectiveness of this filter were also evaluated. An assessment of the radiation dose delivered employing either the standard total filtration (3 mm Al equivalent) or 0.1 mm of erbium filtration added to the standard filtration was undertaken on 21 patients. Image quality was assessed using the Commission of European Communities (CEC) criteria. Significant reductions of 64.6 % in entrance surface (p = 0.0001) and 23.4 % in effective dose (p = 0.0099) were recorded with erbium filtration. Image quality was maintained and the cost per man saved was pound 128. More widespread use of this dose reducing filter is advocated.

Adult↗

PubMed2001

[Cavitation bubble formation during Erbium:YAG laser vitrectomy].

BACKGROUND: Clinical and experimental studies demonstrated the potential advantages of Erbium:YAG laser vitrectomy for posterior segment surgery. However, a detailed knowledge on the laser-tissue interaction is needed for an optimization of new ophthalmic applications. The aim of this experimental work was to investigate the cavitation bubble formation during Erbium:YAG laser vitrectomy and to find optimized laser parameters and the best geometry of the aspiration port of the microsurgical probe. MATERIALS AND METHODS: We investigated the formation of cavitation bubbles in water by high-speed photography. The output energy at the quartz tip reached up to 50 mJ and the laser pulse duration ranged from 50 to 300 microseconds. Various commercially available microsurgery probes were investigated regarding the extent of the cavitation bubbles. RESULTS: The threshold for laser-induced cavitation bubble formation was found to be 0.32 +/- 0.1 mJ for a laser pulse duration of 130 microseconds and a core diameter of 320 microns of the quartz fiber tip. The length of the cavitation bubbles increases with the laser pulse energy up to a length of 1.6 mm at a pulse energy of 10 mJ. In contrast, the size of the vapor bubbles decreases with an increase of the laser pulse duration. A slit-shaped aspiration port led to a 50% smaller volume of the cavitation bubble exiting the port compared with a circular aspiration port. CONCLUSIONS: The optimized laser parameters and microsurgery probe geometry may significantly decrease the risk of intraoperative ocular damages during Erbium:YAG laser vitrectomy.

Animals↗

PubMed1988

The use of added erbium filtration in intraoral radiography.

Using D and E speed film, intraoral exposures were made of a phantom at 70 and 90 kVp, with and without erbium filtration. Measurement of surface exposures indicates substantial reduction when erbium filtration was used. However, there was a visible loss of contrast. The raters agreed that radiographs made with E speed and D speed film, both with and without erbium filtration, were all of adequate diagnostic quality. The radiographs with the highest contrast were consistently preferred by all of the raters.

Erbium↗

PubMed1993

Root resection of endodontically treated teeth by erbium: YAG laser radiation.

Root resection was performed on endodontically treated extracted human teeth exposed to pulsed erbium:YAG laser radiation at energy levels between 50 and 90 mJ/pulse in wet and dry fields. The lased surfaces were examined by optical and scanning electron microscopy. The smooth, clean resected root surfaces, devoid of charring (in wet fields), indicate that the erbium:YAG laser has a potential application in endodontic periapical procedures. In addition, researchers have shown that the zone of thermal damage and carbonization following erbium laser exposure on soft tissues and bone is appreciably less compared with other lasers, and therefore its use may result in improved healing and diminished postoperative discomfort.

Apicoectomy↗

PubMed2000

Comparison of carbon dioxide laser, erbium:YAG laser, dermabrasion, and dermatome: a study of thermal damage, wound contraction, and wound healing in a live pig model: implications for skin resurfacing.

BACKGROUND: Advances in laser technology allow for precise tissue removal and minimal thermal damage. However, mechanisms for cosmetic improvement have not been determined. Investigators have suggested that ablation, collagen shrinkage, and new collagen deposition all contribute to the clinical outcome. OBJECTIVE: In a live farm pig, we examined gross and microscopic effects of thermal and mechanical ablation devices to characterize immediate and long-term mechanisms in skin rejuvenation. METHODS: Two CO(2) lasers, an erbium:YAG laser, a dermabrader, and a dermatome were used to treat flank skin in a farm pig. There were 14 different treatment groups based on device type and working parameters. One to five sites were treated for each group. Wound surface areas were measured before treatment, immediately after treatment, and 7, 17, 23, 30, and 60 days thereafter. Biopsies were performed immediately after irradiation and 2, 7, 17, and 60 days after treatment. RESULTS: For the CO(2) laser-induced wounds, surface area measurements showed that immediate and final wound contraction tended to increase with initial residual thermal damage (RTD) for a range of values, above which immediate contraction remained relatively constant. Although there was no immediate wound contraction with mechanical ablation devices, long-term wound contraction in the dermatome and dermabrasion sites increased with depth of ablation. The erbium:YAG laser sites healed in a manner similar to that of mechanically induced wounds. Wound contraction profiles over time were dependent on depth of RTD and depth of ablation. Sixty days postoperatively, histologic examination showed varying degrees of fibroplasia. Overall, there was greater compaction and horizontal orientation of collagen fibers in those wounds with more than 70 microm of dermal RTD. Grossly, all wounds were similar after 60 days, with the exception of the deep dermabrasion sites, at which clinical scarring was observed. CONCLUSION: Our results show that CO(2) laser resurfacing produces short- and long-term wound contraction that is greater than that induced by purely ablative methods for the same total depth of injury. The erbium laser produced wound contraction profiles similar to those produced by mechanical wounding. The data suggest that initial collagen contraction and thermal damage modulate wound healing.

Animals↗

PubMed1993

An in vitro comparison of the Erbium: YAG laser and the carbon dioxide laser in laryngeal surgery.

This study compares the relative thermal damage caused by a surgical CO2 laser and the Erbium:YAG laser when used to incise the human vocal fold in vitro. Results show that charring is completely eliminated when using the Erbium:YAG laser. The depth of coagulative necrosis adjacent to an incision is reduced from 510 microns (+/- 75) using the CO2 laser to 23 microns (+/- 12) using the Ebrium:YAG laser and at the base is reduced from 125 microns (+/- 45) using the CO2 laser to 12 microns (+/- 8) using the Erbium:YAG laser. The potential advantages regarding post-operative healing after laryngeal surgery are discussed.

Carbon Dioxide↗

PubMed2003

Ablation of cutaneous lesions using an erbium:YAG laser.

BACKGROUND AND OBJECTIVE: This study was performed to evaluate the effectiveness and safety of erbium:YAG laser in removal of cutaneous lesions. STUDY DESIGN: Data were collected after removing 363 benign, pre-malignant and malignant lesions in 27 patients at a dermatology and cosmetic laser surgery center. RESULTS: All lesions were completely removed. Eight of 363 lesions recurred and the histological analysis showed complete removal of one malignant lesion with erbium:YAG laser ablation. There were no long term or permanent complications. CONCLUSION: Erbium:YAG laser is safe and effective in removal of cutaneous lesions.

Adult↗

PubMed1994

Seventeen live births after the use of an erbium-yytrium aluminum garnet laser in the treatment of male factor infertility.

Mechanical partial zonal dissection (PZD) is one of the microinsemination techniques developed to improve the chances of fertilization by in-vitro insemination in subfertile males. We developed a new and safe laser method (erbium laser ablation) for PZD, with the aim of producing a precise opening as well as ablation of some layers of the zona pellucida. From February 1992 to March 1993, 104 couples suffering from male factor infertility were treated in our centre. All patients were affected by severe oligoasthenozoospermia and had previously undergone one failed in-vitro fertilization attempt each. Photoablation of the zona pellucida was induced in 512 oocytes by exposure to an erbium--yytrium aluminium garnet (Yag) laser. The openings obtained were approximately 14 microns in diameter. Of the laser-treated oocytes, 158 (30%) fertilized and 139 (88%) cleaved. Nineteen (18.3%) clinical pregnancies resulted and produced 17 newborns, all in good health. In our series there were four miscarriages, 23 damaged oocytes (4.4%) and 13 with three or more pronuclei (2.5%). Considering that the incidence of damaged oocytes and polyspermy is low, it seems that in some cases of male factor infertility erbium-Yag laser photoablation of the oocyte zona pellucida can be considered a procedure which is effective in enhancing fertilization and which is safe, allowing normal embryo development.

Aluminum↗

PubMed2004

Application of carbon dioxide and erbium:yttrium-aluminum-garnet lasers in inner ear surgery: an experimental study.

BACKGROUND: Surgery of the inner ear requires atraumatic techniques to preserve the sensory structures of the inner ear. With modern laser technology, surgery can be performed without mechanical contact, reducing the risk of direct mechanical trauma. However, energy transfer by laser light has the potential to induce damage by heating, pressure waves, or direct irradiation, depending on the properties of the laser and parameters of application. HYPOTHESIS: The application of laser systems in inner ear surgery may have an advantage over traditional techniques; the carbon dioxide laser in continuous mode with an automated scanning procedure and the erbium:yttrium-aluminum-garnet laser were compared with a mechanical technique, using a diamond drill. METHODS: A cochleostomy in the basal cochlear turn of guinea pigs was created. Thresholds in response to frequency-specific stimuli and clicks were established by recording compound action potentials, both before and after the procedure. RESULTS: The best results in terms of preservation of cochlear function were obtained with the diamond drill. However, a single ear had a complete loss after fracture of the cochlear wall. Mean threshold shifts observed with the carbon dioxide laser were slightly greater, showing mild high-frequency losses, although differences to the group of drilling were not statistically significant. Results with the erbium:yttrium-aluminum-garnet laser showed significantly higher degrees of hearing loss than the other two groups, predominantly in the high-frequency region. CONCLUSIONS: Mechanical opening of the inner ear using a microdrill can be performed with minimal hearing loss; however, it carries the risk of direct trauma to the inner ear. The carbon dioxide laser with a new scanning technology as a noncontact procedure is shown to be effective and safe. It can be regarded as a useful tool in inner ear surgery. The erbium:yttrium-aluminum-garnet laser has a greater potential to cause damage.

Aluminum↗

PubMed2004

Epidermal naevi treated with pulsed erbium:YAG laser.

Epidermal naevi are common and can cause marked cosmetic disability. Ablative laser treatment may be successful in their removal, but may result in significant scarring. Surprisingly the erbium:YAG laser is rarely reported for this indication even though it produces minimal tissue damage. We report our experience using this laser to treat six patients with epidermal naevi. Patients (five female, one male; aged 4-41 years) underwent treatment with pulsed 2940 nm erbium:YAG laser at 0.4-0.45 J/cm(2), 2 mm spot size at 4 pulses/s. All six patients had excellent cosmetic results at follow up ranging from 6 to 60 months. The favourable results were dependent on selection of cases with superficial or small, discrete lesions which could be ablated accurately. The erbium:YAG laser is therefore an effective treatment for relatively nonverrucous or papular epidermal naevi.

Adolescent↗

PubMed2004

The safety and effectiveness of single-pass erbium:YAG laser in the treatment of mild to moderate photodamage.

BACKGROUND: There are several treatment modalities for mild to moderate photodamage. The demand for effective treatments with minimal side effects has increased. OBJECTIVE: The objective of this study was to determine the effectiveness of short-pulsed erbium:YAG laser in treating mild to moderate photodamage. METHODS: Twenty patients were treated with the short-pulse erbium:YAG laser on the face and neck. One pass was given over the entire face with two to three passes over the perioral and periorbital regions. Patients were evaluated for improvement of pigmentary irregularities, skin texture, and fine wrinkles. All side effects were recorded at follow-up visits. Two lasers were used, Sciton and Cynosure CO3, under local anesthesia. RESULTS: There was a 58% reduction in pigment irregularities and a 54% improvement in skin texture. There was minimal improvement in fine wrinkles with one pass. Two and three passes resulted in a 50% reduction in wrinkles. The procedure was minimally painful. Side effects included 3 to 5 days of erythema and edema. Patients returned to work within 3 days on average. There were no infections. Patient satisfaction with the procedure was rated as very good. There was no difference in efficacy or adverse effects with either laser. CONCLUSIONS: One-pass short-pulse erbium:YAG laser in treating photodamage of the face and neck is safe and effective. There are minimal side effects and patients heal within 3 to 5 days.

Erbium↗

PubMed1977

Double-blind study of erbium 169 injection (synoviorthesis) in rheumatoid digital joints.

A double-blind study of erbium 169 injection into rheumatoid digital joints was carried out with saline as control. 201 joints in 36 patients were studied (137 metacarpophalalangeal, 64 proximal interphalangeal). Erbium 169 was injected into 121 joints and saline water into 80 joints. Local injection of corticosteroids was given to both groups. A definite improvement was observed in 55% to 58% of cases with erbium 169 (+prednisolone acetate) and in 26% to 28% of cases with saline (+prednisolone acetate). The difference was highly significant.

Arthritis, Rheumatoid↗

PubMed1979

Erbium--169 versus triamcinolone hexacetonide in the treatment of rheumatoid finger joints.

Erbium--169 was compared with triamcinolone hexacetonide in the topical treatment of 32 patients suffering from rheumatoid arthritis. Erbium--169 was injected into 83 and triamcinolone hexacetonide into 54 proximal interphalangeal or metacarpophalangeal joints. Both treatments produced alleviation of joint pain and swelling and improvement of grip strength. At every check-up (1--18 months) the percentage of remissions was higher after triamcinolone hexacetonide injection than after erbium--169. The difference was significant at 1, 3, and 6 months.

Adult↗

PubMedDate not supplied

Effects of the holmium:YAG and erbium:YAG lasers on endotracheal tubes.

Endotracheal tube (ET) fire is the most frequent complication arising with laser surgery in the upper aerodigestive tract. No data are available about the safety of commonly used ETs when used with recently developed high-energy pulsed lasers, working with only a minimal thermal component but mainly photoablative. A comparative in vitro study was performed with three types of endotracheal tubes to assess their resistance to wall and cuff damage by the laser beams of two pulsed infrared solid-state lasers. ET perforation was attempted with the erbium:YAG (lambda = 2,930 nm) and holmium:YAG (lambda = 2,120 nm) lasers. For all experiments, a repetition rate of 5 Hz was used. The 2.5-microseconds holmium:YAG pulses were coupled into a nylon fibre of 400 microns diameter. The 2.0-microseconds erbium:YAG laser pulses were applied to ETs through a lens system providing a spot size diameter of 200 microns. Polyvinyl chloride and silicon ET segments were exposed to laser pulse energies from 97 to 500 mJ in the presence of different anaesthetic gas mixtures. The time from the onset of exposure to tube perforation was recorded. Thermal gradients following laser application were measured. Laser exposure was continued for up to 90 s, unless tube ignition occurred. At all energy levels tested, the photo-ablative mechanism of laser-tube interaction, with few thermal components, led to laser-induced tube ignition if an FiO2 > 21% for the holmium:YAG and 34% for the erbium:YAG laser was established. With increasing pulse energies, ET segments ignited sooner. MLT tubes performed best in the present safety test.

Aluminum Silicates↗

PubMed1992

Dose reduction by the use of erbium filtration in a general radiographic room.

The conventional aluminium filtration of a general purpose X-ray tube in a district general hospital was replaced by an erbium filter for a 2-month period. The resulting reduction in skin dose was measured for a number of examinations using thermoluminescent dosimetry. The change in effective dose equivalent was calculated from these measurements and compared with previous theoretical estimates. The use of the erbium filter had no effect on radiograph quality. It was concluded that the use of an erbium filter resulted in a worthwhile reduction in radiation dose, and was a cost-effective method of dose reduction.

Aluminum↗

PubMed2003

Gingival depigmentation by erbium:YAG laser: clinical observations and patient responses.

BACKGROUND: Melanin, carotene and hemoglobin are the most common natural pigments contributing to the normal color of the gums. Although physiologic and ethnic melanin pigmentation is not a medical problem, complaints about "black gums" are common. Gingival depigmentation has been carried out using non-surgical and surgical procedures. Recently, laser ablation has been recognized as a most effective, pleasant and reliable technique. METHODS: The study included 10 patients who requested cosmetic therapy for melanin pigmented gums. Treatment was carried out using an erbium:YAG laser. The laser beam was set at 500 mJ/10 pulses/second. The beam was defocused to produce a 3 mm diameter circle, thus reducing the beam penetration to 2 to 4 microm/pulse while increasing the treated surface. The "brush" technique was applied until the gingival surface appeared clinically free of pigmentation. Patients were observed for 6 months. Each patient filled out a personal evaluation questionnaire for clinical analysis. RESULTS: Between 500 to 1,100 pulses/cm2 were recorded and a total of 800 to 2,200 pulses were required per patient, depending on the epithelium thickness and pigmentation. Treatment required only topical anesthesia. Healing was uneventful and required no supportive therapy. None of the patients experienced severe pain during or post-operatively. Mild pain or itching was common during the first week. Treatment was reported as generally pleasant. Follow-up during the 6 months showed no recurrences. CONCLUSIONS: Depigmentation of gingival melanin pigmentation by erbium:YAG laser radiation in a defocused mode was a safe and effective procedure. The esthetic results were pleasing and healing was uneventful. Since the erbium:YAG laser is available in the dental office, it seems to be the laser of choice for this procedure.

Adolescent↗