In the experiment, the features of laser interstitial thermotherapy (LITT) with wavelengths of 0.92; 0.97; 1.06; 1.56 and 1.9 μm and the possibility of estimating photothermal interactions by means of ultrasoundwere studied. Ultrasound clearly determined the tissue coagulation zone without differentiating it from carbonation. The phenomenon of "breakdown" of tissues during LITT was revealed. Most often at 1.9 Μm-LITT there was a rapid transfer of heat by gas bubbles through the vessels. Intima of the vessels was fired. Ultrasound control of LITT in 145 of 781 children with vascular tumors increased its effectiveness, reducing the number of repeated sessions by 3.2 times.
Two low invasive laser technologies for treatment of degenerative-dystrophic bone diseases in children are presented.
The first is the transcutaneous laser osteoperforation developed by us and initially applied for treatment of different
inflammatory and traumatic diseases (osteomyelitides, osteal and osteoarticular panaritiums, delayed unions, false joints,
and others). Now the technology was applied to treatment of aseptic osteonecrosis of different localizations in 134
children aged from 1 to 16 years, including 56 cases with necrosis of femoral head (Legg-Calve-Perthes disease), 42 with
necrosis of 2nd metatarsal bone head (Kohler II disease), and 36 with necrosis of tibial tuberosity (Osgood–Schlatter
disease). The second technology is the laser intracystic thermotherapy for treatment of bone cysts. The method was
applied to 108 children aged from 3 to 16 years with aneurismal and solitary cysts of different localizations. In both
technologies a 970 nm diode laser was used. The suggested technologies increase the efficiency of treatment, reduce its
duration, can be performed on outpatient basis, which resulted in great economical effect.
A few new low invasive fiber laser technologies for treatment of 1) capillary malformations (port-wine stains), 2) venous, arterial, and arteriovenous malformations, 3) lymphatic malformations of 3 types: micro, small and large-cystic lymphangiomas are presented in this work. There were applied 1.56 μm laser distant photocoagulation, 1.56 μm laser endovascular thermotherapy, 1.9 μm laser instant ablation, 1.9 μm laser interstitial thermotherapy, and 1.9 μm laser excision. The technologies were applied to about 300 patients. Good clinical and esthetic results have been achieved in great majority cases.
Results of application of low invasive laser technology (developed by authors: Proc. SPIE 5863, 107-115 (2005),
Russian Federation patent No.2290228 of.27.12.06) to treatment of hemangiomas in children are presented and analyzed
in this work. From 2001 the technology was applied to about 1500 children with more than 2000 hemangiomas. Majority
of them were complicated ones: belong to cavernous or combined types or (and) were localized on problem places: on
face near eyes, nose, and lips, on auricles, on perineum near anus and genitals, in respiratory and gastrointestinal tracts.
Diode laser with wavelength 920, 970, and 1060 nm at distant and interstitial irradiation were applied. In case of need
there applied endoscopes. Excellent and good results have been achieved in 94% cases; there was a significant
improvement in the rest cases.
The method of laser osteoperforation was developed in experiment and then applied for treatment of 508 patients with
osteomyelitis, 51 patients with nonunion and pseudo-joint and 34 patients with different forms of osteochondropathy.
The clinical trial proved the efficiency of laser osteoperforation for treatment of both inflammatory and destructive bone
diseases. This method is minimally invasive, promotes rapid reduction of bone and soft tissue inflammation, and
apparently stimulates bone reparation.
Infra-red diode laser with wavelength 1060 nm was used for combined treatment of 163 children aged from 21 days to 13 years with 221 hemangiomas. For interstitial coagulation a power of 1.8-2 W and a power density of 5-90 J/cm3 were used in continuous mode. For distant coagulation pulse mode was applied with pulse/pause duration 30-50/200-250 ms, average power 1.3-2 W, and power density 65-450 J/cm2. 197 (89.1 %) hemangiomas were capillary, 7 (3.2 %) cavernous, and 17 (7.7 %) combined (combination of capillary and cavernous hemangiomas). The area of hemangiomas ranged from 6 mm2 to 48 cm2. For the majority (193, 87.3 %) of hemangiomas one session of photocoagulation was enough to achieve a good cosmetic effect. However, 28 (12.7 %) hemangiomas were treated repeatedly, 11 (5%) of them needed 4-7 sessions. In 8 children with cavernous and combined hemangiomas both distant and interstitial laser coagulation were used. In all, good or excellent results were obtained in 96,3 % of the patients. In 6 (3.7%) patients with extensive combined hematomas the considerable improvement was achieved.