Section: 
Diseases of the lymphoepithelial pharyngeal ring and neck
Diseases of the lymphoepithelial pharyngeal ring and neckLaser technologies in pediatric tonsil and adenoid surgery
V. V. Dvoryanchikov (1), L. E. Shapovalov (2), M. V. Drozdova (3), A. V. Karelin (4), N. V. Yaremenko (5)
(1), (2), (3), (4), (5) Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russian Federation
UDK: УДК 616.323-007.61- 053.2-089.87:615.849.19
DOI: https://doi.org/10.18692/1810-4800-2025-4-50-55
ABSTRACT
Abstract. The problem of diagnosing and treating chronic diseases of the ENT organs continues to be a subject of close attention from otolaryngologists, pediatricians, infectious disease specialists, and immunologists. This issue is especially relevant in childhood and leads to a decrease in overall body resistance, the development of transient immunodeficient states, and delays in physical and psychomotor development. Adenotonsillar pathology often causes allergic reactions, hinders administration of preventive vaccinations, and negatively impacts the quality of life and health at various age periods. Chronic diseases of the lymphoid ring of the pharynx in children require the search for effective and safe treatment methods that are confirmed to have high efficacy. Laser technologies, particularly the CO2 lasers, possess significant potential. Among the advantages of laser surgery are the reduced risk of postoperative bleeding, increased sterility, minimal damage to surrounding tissues, and improved intraoperative hemostasis. To implement this method in surgical practice, it is necessary to select the optimal parameters for impact (exposure, modes) on the biological tissues of the child’s body. Objective. To determine the optimal operating modes of the CO2 laser (continuous: CW and superpulsed: SP) for the surgery of lymphoid tissue in children. Materials and methods. An experimental ex vivo study on 160 samples of palatine tonsils (children aged 3–15 years). The study assessed the depth of coagulation and thermal damage depending on the modes of work of the CO2 laser: CW (15–40 W) and SP (15 W), the depth of exposure (4, 6, 8, 9), and the number of impulses (1–2). Results. When using the SP mode, thermal damage reached 181–1355 µm (without carbonization effect); when using the CW mode, thermal damage reached up to 2,360 µm, which is characterized by a high risk of carbonization at power levels above 20 W. Conclusion. The superpulsed mode of the CO2 laser is recommended for children with adenotonsillar pathology as a method that ensures minimal thermal damage.
Publication date:
13.08.2025
Keywords:
adenotonsillar pathology, laser surgery, CO2 laser, thermal injury, children For citation:
Dvoryanchikov V. V., Shapovalov L. E., Drozdova M. V., Karelin A. V., Yaremenko N. V. Laser technologies in pediatric tonsil and adenoid surgery. Russian Otorhinolaryngology. 2025;24(4):50-55. (In Russ.) https://doi.org/10.18692/1810-4800-2025-4-50-55