Thulium laser safe mode selection for in vitro sialolithotripsy; [Выбор безопасного режима работы тулиевого лазера при сиалолитотрипсии in vitro]

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. © 2024 Clinical Dentistry LLC. All rights reserved.