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On the merits of using angled fiber tips in office-based laser surgery of the vocal folds
Author(s) -
Isabelle A. Chan,
Jesse F. d'Almeida,
Alex J. Chiluisa,
Thomas L. Carroll,
Yuxiang Liu,
Loris Fichera
Publication year - 2021
Publication title -
pubmed central
Language(s) - English
Resource type - Conference proceedings
SCImago Journal Rank - 0.192
H-Index - 176
pISSN - 0277-786X
DOI - 10.1117/12.2580454
Subject(s) - laser , larynx , computer science , vocal folds , fiber laser , fiber , laser surgery , optical fiber , laser light , optics , biomedical engineering , materials science , surgery , medicine , telecommunications , physics , composite material
Office-based endoscopic laser surgery is an increasingly popular option for the treatment of many benign and pre-malignant tumors of the vocal folds. While these procedures have been shown to be generally safe and effective, recent clinical studies have revealed that there are a number of challenging locations inside the larynx where laser light cannot be easily delivered due to line-of-sight limitations. In this paper, we explore whether these challenges can be overcome through the use of side-firing laser fibers. Our study is conducted in simulation, using three-dimensional models of the human larynx generated from X-ray microtomography scans. Using computer graphics techniques (ray-casting), we simulate the application of laser pulses with different types of laser fibers and compare the total anatomical coverage attained by each fiber. We consider four fiber types: a traditional "forward-looking" fiber - not unlike the ones currently used in clinical practice - and three side-firing fibers that emit light at an angle of 45, 70, and 90 degrees, respectively. Results show that side-firing fibers enable a ~70% increase in accessible anatomy compared to forward-looking fibers.

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