Is the KTP laser effective in tonsillectomy?

Thirty-eight patients underwent a randomized double-blind trial using the KTP laser for tonsillectomy on one tonsil and standard dissection tonsillectomy on the other tonsil. Blood loss was less on the laser side. However, pain though initially slightly less on the laser side (days 1 and 2 post-operation) was worse on the laser side at 2 weeks due to delayed healing of the tonsillar bed. There were no primary or reactionary haemorrhages but a 15% incidence of secondary haemorrhage on the laser side.     

KTP-532 laser tonsillectomy: a comparison with standard technique

It has been stated that laser excision of oral and oropharyngeal lesions result in less intraoperative blood loss, reduced postoperative pain, and quicker wound healing, but few controlled studies have been done to substantiate these claims. A study was undertaken to examine the benefits of the KTP-532 laser in a group of 31 patients who underwent tonsillectomy. One tonsil was removed with the KTP-532 laser and the other was excised with conventional dissection and snare technique. Patients were not told which tonsil was removed with the laser. Pain, healing, and intraoperative blood loss comparing one side to the other was assessed. On the evening of surgery, 83% of patients selected the side that underwent standard dissection and snare tonsillectomy as the most painful. By midweek, however, approximately equal numbers of patients selected the laser side as the most painful. At the end of 1 week, 63% of patients felt more pain on the laser dissection side. Possible reasons for these results are discussed. Intraoperative blood loss was significantly reduced with the use of the KTP-532 laser, but healing was not accelerated.     

A prospective double‐blind randomized controlled trial comparing the suitability of KTP laser tonsillectomy with conventional dissection tonsillectomy for day case surgery

Tonsillectomy using a KTP laser has been performed increasingly but is not a routinely practised technique in the UK. In the USA, tonsillectomy is often performed as a day case procedure but, here in the UK, it is still standard practice to admit patients for overnight stay. We present the largest prospective double‐blind randomized controlled trial to date (151 patients) comparing KTP laser with standard dissection tonsillectomy and assess the suitability of both procedures for day case surgery. We found that there was significantly less peroperative haemorrhage if tonsillectomy was performed using the KTP laser, but it did cause more postoperative pain, more depression in mood and a higher rate of both reactionary and secondary haemorrhage, which was not significant when compared with conventional dissection. There was no difference in operating time, and over 40% of patients in each group needed overnight admission. We conclude that KTP laser tonsillectomy offers no benefit apart from less intraoperative bleeding over standard dissection tonsillectomy. Discharge from hospital after tonsillectomy was found to be unpredictable. Tonsillectomy is therefore an unsuitable procedure for planned surgery through a day unit, but approximately 58% of patients could be discharged on the same day from an extended day surgery unit, and the rest have one night in hospital.     

Poor results of KTP Laser tonsillectomy compared with conventional dissection: a prospective clinical trial

The aim of this study was to compare the clinical outcome of KTP Laser tonsillectomy with conventional dissection tonsillectomy. Seventy-four Laser tonsillectomy patients (mean age 14 years, range 2–91 years) were compared prospectively with 157 conventional dissection tonsillectomy patients (mean age 18 years, range 2–71 years). KTP Laser tonsillectomy was performed using 0.6 fibre optic cable at 10 Watts continuous. Conventional dissection tonsillectomy was by standard techniques. Operating time, intra-operative bleeding, postoperative pain at 1, 7 and 14 days, incidence of delayed healing, postoperative bleeding and hospital readmission were compared. There was no significant difference in operating time between Laser and conventional tonsillectomy. At days 1, 7 and 15 the Laser group reported significantly higher pain scores than the conventional group (P < 0.0001, Mann–Whitney U test) and showed evidence of delayed healing at 14 days (P < 0.0001, χ² test). The Laser group had less intra-operative bleeding (P < 0.02) but this effect disappeared when the confounding effect of age was controlled by analysing children under 12 separately. KTP Laser tonsillectomy results in significantly more postoperative pain and delayed healing compared with conventional dissection tonsillectomy. It is no quicker than conventional dissection tonsillectomy. Blood loss was less in the Laser group but this may be accounted for by younger age. KTP Laser should not replace conventional tonsillectomy as standard technique. It may have a limited role where minimizing intra-operative blood loss is an overriding consideration.     

早期声门型喉癌钬激光与CO2激光手术对比研究

目的 比较钬激光与CO2激光手术治疗早期声门型喉癌临床疗效.方法 回顾性分析激光手术治疗早期声门型喉癌91例的患者临床资料(Tis,T1 N0 M0).依据治疗方式分为钬激光手术组56例,CO2激光手术组35例.对两组患者手术时间、出血量、并发症、住院时间、创面恢复时间和生存率等进行分析.结果 钬激光组与CO2激光组在...     

A prospective double-blind randomized controlled trial comparing the suitability of KTP laser tonsillectomy with conventional dissection tonsillectomy for day case surgery

Tonsillectomy using a KTP laser has been performed increasingly but is not a routinely practised technique in the UK. In the USA, tonsillectomy is often performed as a day case procedure but, here in the UK, it is still standard practice to admit patients for overnight stay. We present the largest prospective double-blind randomized controlled trial to date (151 patients) comparing KTP laser with standard dissection tonsillectomy and assess the suitability of both procedures for day case surgery. We found that there was significantly less peroperative haemorrhage if tonsillectomy was performed using the KTP laser, but it did cause more postoperative pain, more depression in mood and a higher rate of both reactionary and secondary haemorrhage, which was not significant when compared with conventional dissection. There was no difference in operating time, and over 40% of patients in each group needed overnight admission. We conclude that KTP laser tonsillectomy offers no benefit apart from less intraoperative bleeding over standard dissection tonsillectomy. Discharge from hospital after tonsillectomy was found to be unpredictable. Tonsillectomy is therefore an unsuitable procedure for planned surgery through a day unit, but approximately 58% of patients could be discharged on the same day from an extended day surgery unit, and the rest have one night in hospital.     

Tonsillektomie mit dem ultraschallaktivierten Skalpell Erste Ergebnisse zur Technik mit dem Ultracision Harmonic Scalpel®

BACKGROUND: Tonsillectomy requires an efficient intra- and postoperative hemostasis. The ultrasonically activated scalpel (UAS) uses high-frequency ultrasonic energy to perform tissue dissection and coagulation simultaneously. The present prospective study represents the first published results of UAS in tonsillectomy. METHOD: 60 patients with tonsillectomy were examined in regard of intra- and postoperative hemostasis, wound healing and postoperative pain. Also, the quality of the histopathological specimen was evaluated. RESULTS: In 90% of tonsillectomies by UAS efficient intraoperative hemostasis did not require suture ligature. In 10% additional ligation was required for reason of arterial bleeding. Postoperative bleeding did not occur at all, wound healing was uneventful. Surgery related postoperative pain was not intensified. The histopathological evaluation of specimen was not impaired. CONCLUSION: The UAS offers a tissue dissection with efficacious intra- and postoperative hemostasis. Compared to the conventional tonsillectomy the ultrasonical technique of tonsillectomy has especially in children, in anaemic patients and in the surgery of tonsillar malignomas significant advantages.     

咽腭弓肌黏膜瓣闭合扁桃体等离子术后创面的临床疗效

目的 对扁桃体等离子切除术的术式进行改进,分析咽腭肌黏膜瓣闭合扁桃体等离子术创面对术后疗效的改善情况。 方法 对需行扁桃体等离子切除术患者进行随机分组。105例行常规扁桃体等离子切除术(大多数囊内切除),94例在扁桃体等离子切除后制作局部咽腭肌黏膜瓣闭合扁桃体窝创面。对两组患者的术后疼痛、创面反应及出血情况进行分类统计,分析比较应用咽腭肌黏膜瓣修复的临床效果。 结果 在术后第1至第7天,实验组与对照组患者间的疼痛程度、创面反应情况及出血并发症的发生均有差异。实验组不同层次疼痛程度的病例数明显少于对照组,术后创面反应观察中,实验组白膜脱落时间较对照组明显缩短,出血概率明显减低。 结论 应用咽腭肌黏膜瓣闭合扁桃体等离子切除后创面操作简便,可明显改善患者术后疼痛,促进创面愈合,减少创面术后出血概率。     

KTP‐532 laser‐assisted endoscopic nasal sinus surgery

KTP‐532 laser‐assisted endoscopic nasal sinus surgery The present study is meant to give an overview of the application of KTP lasers in endoscopic sinus surgery and to give an account of the experience gained in the course of 24 operations. Laser‐assisted FESS was performed in 24 patients (13 on the right side and 11 on the left side). Sixteen men and eight women were treated for chronic maxillary sinusitis. Diagnostic criteria of chronic maxillary sinusitis included at least 3 months history of intermittent or persistent facial pain, intermittent or persistent fever, tenderness or headache over the areas of the maxillary, ethmoid or frontal sinuses, purulent discharge from nasal passages or nasopharynx, and radiographic evidence of opacification on CT scans. Traditional FESS surgery was performed on the one side and KTP laser‐assisted surgery on the other side. CT was performed in each case. The operations were carried out under local anaesthesia. The KTP laser was delivered via an optical fibre (0.6 mm) and was used for bone ablation, incision, vaporization and coagulation. Patient symptoms were recorded using a self‐administered questionnaire preoperatively, and postoperatively on weeks 1, 4, 12 and 24. Blood loss on the laser‐assisted operations' side was minimal. The improvement of the symptoms (pain, sensation of fullness, discharge) during weeks 1 and 4 proved to be significant (P < 0.05) in the case of both techniques. The cumulated average of the point scores on the laser‐assisted side was higher: especially postoperative week 1. Of the parameters assessed in the course of healing, oedema prevailed on the laser‐assisted side, while crusting was characteristic in the traditional operation site. We conclude that laser‐assisted FESS surgery is as effective as traditional endonasal sinus surgery. Its advantage is that it offers excellent haemostasis, as the use of ‘star pulse’ mode allows accurate bone work. No complications were observed. The disadvantage of the laser‐assisted procedure is that the instrument is expensive and it is time consuming.     

Thermal welding versus cold dissection tonsillectomy: a prospective, randomized, single-blind study in adult patients

OBJECTIVES: We performed a single-blind, prospective, randomized, controlled clinical study to compare the rates of postoperative morbidity in adults undergoing thermal welding tonsillectomy versus cold dissection tonsillectomy. METHODS: Thirty-two adults with recurrent tonsillitis who were scheduled for elective tonsillectomy were randomized to either thermal welding or cold dissection tonsillectomy groups. The main outcome measures included intraoperative blood loss, intensity of postoperative pain expressed on a 10-cm visual analog scale (with 0 representing no pain and 10 representing the worst possible pain), day of cessation of significant pain (ie, a pain score of at least 7), and presence of postoperative hemorrhage estimated on a 3-point scale (with 0 representing no bleeding, 1 representing minor bleeding, and 2 representing major bleeding). Additional outcome measures included total analgesic requirements, last day of receipt of analgesics, presence of nausea and/or vomiting, and wound healing after 10 days of surgery. RESULTS: The rate of intraoperative blood loss was significantly lower in the thermal welding group (p < .0001). Patients who had thermal welding tonsillectomy also showed a general trend toward lower pain scores, and this difference was statistically significant from the first to the fourth postoperative days (p < .05). Cessation of significant pain also occurred 3 days earlier in this group (p < .05). No significant difference was observed regarding pain medication, nausea and/or vomiting, postoperative hemorrhage, or wound healing. CONCLUSIONS: Thermal welding tonsillectomy is a relatively safe and reliable method with significantly less postoperative morbidity than cold dissection tonsillectomy.     

The efficacy of honey for ameliorating pain after tonsillectomy: a meta-analysis

Postoperative pain and wound healing following tonsillectomy can result in dissatisfaction for the patient. However, there is no consensus on whether postoperatively administered honey effectively reduces morbidity after tonsillectomy. Therefore, a systematic review with a meta-analysis of the efficacy of honey as a treatment for postoperative pain and wound healing was performed. Two authors independently searched the database records (MEDLINE, SCOPUS, and Cochrane databases) dating from inception to June 2014. Studies comparing postoperative oral administration of honey with administration of placebo where the outcomes of interest were pain and wound healing on postoperative days were included. Baseline study characteristics, study quality, numbers of patients in steroid-treated and control groups, and treatment outcomes were extracted. Sufficient data for meta-analysis were retrieved from 4 trials with a total of 264 patients. We analyzed patient-reported pain scores and quantities of administered analgesics during the first 5 postoperative days. The pain score was significantly decreased in the honey-treated patients in comparison with the placebo-treated patients on postoperative day 1 only, but the analgesic intake of the honey-treated patients on the first 5 postoperative days was significantly less than that of the placebo-treated patients. In addition, honey significantly increased tonsillectomy bed wound healing in comparison with placebo during the first 2 weeks after surgery. This meta-analysis shows that postoperative administration of honey after tonsillectomy significantly reduces pain and promotes wound healing. Further trials comparing honey with good research methodology should be conducted to confirm these results.     

Coblation versus unipolar electrocautery tonsillectomy: a prospective, randomized, single-blind study in adult patients

OBJECTIVES: To determine if the coblation tonsillectomy (subcapsular dissection) results in less postoperative pain, equivalent intraoperative blood loss, equivalent postoperative hemorrhage rates, and faster healing compared with tonsillectomy was performed using unipolar electrocautery in adult patients. STUDY DESIGN: The authors conducted a prospective clinical trial. METHODS: Forty-eight patients underwent tonsillectomy and were randomly assigned to have one tonsil removed with coblation and the other with unipolar electrocautery. Outcome measures included time to remove each tonsil, intraoperative blood loss, patient-reported pain, postoperative hemorrhage, and amount of healing 2 weeks after surgery. RESULTS: Mean time to remove a single tonsil with coblation and electrocautery was 8.22 minutes and 6.33 minutes, respectively (P = .011). Mean intraoperative blood loss for each technique was less than 10 mL. Postoperative pain was significantly less with coblation as compared with electrocautery: 18.6% less painful during the first week of recovery. Seventy percent of blinded patients identified the coblation side as less painful during the overall 14-day convalescent period. Postoperative hemorrhage rates (2.1% for coblation and 6.2% for electrocautery) were not significantly different. No difference in tonsillar fossa healing was observed between the two techniques 2 weeks after surgery. During nine of the 48 surgeries, wires on the tip of the coblation handpiece experienced thinning to the point of discontinuity while removing a single tonsil. CONCLUSIONS: Coblation subcapsular tonsillectomy was less painful than electrocautery tonsillectomy in this 48-patient group. On average, intraoperative blood loss was less than 10 mL for both techniques. Postoperative hemorrhage rates and the degree of tonsillar fossa healing were similar between the two techniques. The coblation handpiece experienced degradation of vital wires in 18% of cases necessitating the use of a second, new handpiece.     

A comparison of the hearing results of KTP and Erbium YAG laser stapedotomy

Conclusion. Our data prove that lasers are safe and useful instruments in stapes surgery. Good postoperative results can be attained in both KTP and Er: YAG lasers. There was no significant inner ear damage related to the Er: YAG laser use. Objective. To compare the postoperative results of stapedotomies performed with KTP and Erbium: YAG lasers in patients with otosclerosis in order to assess the risk of Er: YAG for the inner ear. Patients and methods. The charts of 152 consecutive adult patients who underwent primary laser stapedotomies for otosclerosis from 1999 to 2005 were reviewed. One hundred and thirty-seven stapedotomies (98 patients) were performed using the KTP laser and 54 stapedotomies (54 patients) were performed with Er: YAG laser. All the patients were separated in two groups according to the type of laser, which was used. Hearing results were analyzed according to the Committee on Hearing and Equilibrium Guidelines of the American Academy of Otolaryngology—Head and Neck Surgery. Pure-tone audiometry was performed before the surgery, three months and one year postoperatively. Results. The study indicated that KTP and Er: YAG stapedotomies have similar rates of the air-bone gap closure. There was no significant postoperative sensorineural hearing loss found in both techniques.     

Preincisional infiltration of tonsils with ropivacaine in post-tonsillectomy pain relief: double-blind, randomized, placebo-controlled intraindividual study

OBJECTIVE: To determine whether pre-emptive ropivacaine has an influence on postoperative pain in adult patients undergoing tonsillectomy. DESIGN: A prospective, randomized, double-blind, placebo-controlled clinical trial. SETTING: University hospital. PATIENTS: The study included 20 adult patients undergoing elective tonsillectomy. Anesthetic induction and maintenance, dissection tonsillectomy, hemostasis techniques, and postoperative analgesic treatment were standardized for all patients. Before the onset of incision, one tonsillar fossa was administered 5 mL of 2% ropivacaine hydrochloride with epinephrine, whereas the other side received 5 mL of 0.9% saline with epinephrine and was designated as the control side. MAIN OUTCOMES MEASURES: For each side, postoperative pain, otalgia, operating time, amount of intraoperative blood loss, and postoperative hemorrhage were assessed. The intensity of postoperative pain was measured at rest and when the patient was drinking and was scored on a visual analogue scale. The patients were followed up for 10 days after surgery. RESULTS: There was no statistically significant difference in the amount of intraoperative hemorrhage and operation time between sides (p > .05). The constant postoperative pain in the ropivacaine side at rest was significantly less than in the placebo side on days 1, 2, 5, and 6 (p < .05). The post-tonsillectomy pain experienced in the ropivacaine side when swallowing was significantly less than that in the placebo side throughout the study period except on day 10 (p < .05). CONCLUSION: Based on the present findings, preincisional infiltration of ropivacaine 2% appears to be effective against both early and late postoperative pain, especially on swallowing, following tonsillectomy in adults.     

低温等离子射频消融与CO2激光手术治疗早期声门型喉癌疗效的Meta分析

目的 采用Meta分析的方法评价支撑喉镜下低温等离子射频消融与CO₂激光治疗早期声门型喉癌的临床疗效。 方法 计算机检索PubMed、EMbase、Medline、维普、万方、CNKI数据库。检索年限从建库至2019年5月1日。同时手检纳入文献的参考文献。根据纳入标准和排除标准筛选关于比较支撑喉镜下低温等离子射频消融术与CO₂激光手术治疗早期声门型喉癌疗效的文献。由2人单独进行文献的筛选、数据提取及文献的评价,使用Revman 5.3软件进行Meta分析。 结果 共纳入10个研究,1 055例患者。Meta分析结果显示:与CO₂激光手术相比,低温等离子射频消融术显著降低了患者的手术时间［SMD=-2.97,95%CI(-4.05,-1.90),P<0.00 001 ］、术后黏膜恢复更快［OR=5.53,95%CI(2.84,10.78), P<0.00 001］、术中出血量更多［SMD=-0.73,95%CI(0.09,0.71),P=0.01］,以上两种手术方式相比差异有统计学意义。复发率［OR=0.79,CI95%(0.46,1.36), P=0.39］、术后疼痛程度［SMD=-0.17,95%CI(-0.43,0.08),P=0.18］和术后发声质量［SMD=-0.21,95%CI(-1.13,0.71), P=0.65］两种治疗方式相比差异无统计学意义。手术时间及复发率的漏斗图未发现明显发表偏倚。 结论 低温等离子射频消融术治疗早期声门型喉癌在手术时间和术后黏膜恢复方面优于CO₂激光手术,但低温等离子射频消融术的术中出血量较多,而复发率、术后疼痛程度和术后发声质量,两种治疗方式相比差异无统计学意义。     

Randomized‐controlled study comparing post‐operative pain between coblation palatoplasty and laser palatoplasty1

Objectives: This study aimed to evaluate differences in post‐operative pain comparing KTP laser‐assisted uvulopalatoplasty without tonsillectomy (LAUP) with a new described surgical method: coblation uvulopalatoplasty with tonsillectomy (CP). We also evaluate the impact of each surgical technique in reduction of snoring loudness. Material and methods: Single blind randomized‐controlled trial. From a population of 41 consecutive patients on the waiting list for uvulopalatoplasty for simple snoring, the study group was reduced to 17 CP and 13 LAUP. Post‐operative pain and reduction of snoring loudness were recorded using visual analogue scales (VAS) during the first 15 post‐operative days. Post‐operative snoring loudness was documented for 1‐year period. Results: Both groups had similar post‐operative pain during the first seven post‐operative days. A statistically significant reduction in post‐operative pain was observed in the CP group after day 8, and maintained until the end of the study. Reduction of snoring loudness was significant in both groups, but no differences were observed between them. Discussion: Coblation uvulopalatoplasty compared with LAUP demonstrates a reduction in post‐operative pain, significant after the first post‐operative week. The collateral thermal injury caused by laser is responsible for the slow‐healing rate and maintained post‐operative pain. Coblation dissociates tissue at lower temperatures with minimal collateral thermal injury and consequently faster and less painful recovery. Both surgical procedures have significant and similar reduction in snoring loudness. Conclusions: Both methods are adequate treatment options for snoring. The less painful recovery in CP promotes this surgical technique as our preferred choice for palate surgery.     

Can mucosal sealing reduce tonsillectomy pain?

OBJECTIVE/HYPOTHESIS: The hypothesis tests whether sealing the tonsillectomy field with posterior pillar mucosa can prevent unwanted outcomes in pediatric tonsillectomy. STUDY DESIGN: A prospective, randomized, single blinded study was conducted on a sample of 39 children between 3 and 15 years of age. After dissection and snare tonsillectomy, the tonsillar fossa was covered on one side using the palatopharyngus mucosa and the other side is used as control. Pain scores, healing, edema and infection at the operation site were investigated. METHODS: The tonsillectomy sites were randomly assigned into one of two groups. First group contained the ones with mucosal flap sealed over the operation site and the second group was kept as control with the operation site left uncovered. All of the patients received mild analgesics. The pain assessment is done on Days 1, 3, 5, 7 and 10 postoperatively, by using Wong-Baker faces visual analog scale. On the 10th postoperative day, the operation field of each side is scored separately for edema, healing and infection. Statistical investigation was performed through a software program. RESULTS: On first postoperative day, pain level difference was not statistically significant between the two groups (p>0.01). But from 3rd to 10th postoperative day, the pain level was found out to be lower in the mucosa sealed site (p<0.01). On the 10th postoperative day, while the edema was significantly more (p<0.01), healing was better (p<0.01) at the sutured site. Postoperative infection at operation site was not different between the groups (p>0.01). CONCLUSION: Covering tonsillectomy field with mucosal palatopharyngeal arch flap significantly reduces pain after third postoperative day. The flap side had better healing when compared to denuded site. But the sutures in the mucosal flap may cause more tissue edema. Sutures have no significant effect on postoperative infection. Thus, mucosal flap may be used as an adjuvant surgical technique to decrease tonsillectomy pain of children in addition to the analgesic medication.     

低温等离子刀对比双极电凝镊在扁桃体切除术中治疗效果观察

目的分析变应性鼻炎(AR)患者接受鼻腔冲洗治疗的临床疗效。方法将2019年6月~2020年8月作为研究时间段,选取期间我院接诊的78例AR患者,另将随机数字表法作为分组依据,将全部病例分为对照组(行常规治疗,纳入39例)、研究组(加用鼻腔冲洗治疗,纳入39例),对组间气道反应性、症状消失时间展开分析。结果(1)组间气道反应性指标在治疗前无明显差异,P>0.05;研究组共振频率(Fres)、中心气道阻力(R20)、气道总阻力(R5)在治疗后低于对照组,P<0.05;(2)研究组鼻塞、流涕、喷嚏、鼻痒消失时间均少于对照组,P<0.05。结论鼻腔冲洗对改善AR患者气道反应、临床症状均有明显效果,值得推广。     

Effects of Scalpel,Electrocautery, and CO2 and KTP Lasers on Wound Healing in Rat Tongues

Objective: Evaluate wound healing of incisions created by the scalpel, electrocautery, CO2 laser, and potassium titanyl phosphate (KTP) laser in the upper aerodigestive tract in an animal model. Study Design: Prospective randomized study in an animal model. Methods: Postoperative oral intake, histologic depth of injury, and tensile mechanical strength were measured in rat tongues after creating incisions using a scalpel, electrocautery, CO2 laser, and KTP laser. An unpaired, two-tailed Student's t-test was used to compare results between the experimental groups. Results: Oral intake, indirectly assessed by postoperative weight loss, by the third postoperative day was significantly decreased in the electrocautery (P = 0.004), CO2 laser (P = 0.001), and KTP laser (P = 0.0001) groups as compared with the scalpel group. The depth of the wound healing, as assessed by histologic examination, was successively greater for the scalpel (75 ± 13 μm), electrocautery (110 ± 10 μm), CO2 laser (145 ± 10 μm), and KTP laser (195 ± 23 μm) groups. However, this difference was only statistically significant for the CO2 laser (P = 0.006) and KTP laser (P = 0.01) groups relative to the scalpel group. Wounds created by the KTP laser had the lowest strength (76.5 ± 6.9 kPa) as compared with the CO2 laser (156 ± 28.4 kPa), electrocautery (153 ± 15.7 kPa), and scalpel groups (249 ± 61.8 kPa). This difference was only statistically significant for the KTP laser group (P = 0.02) when compared with the scalpel group. Conclusions: Wounds created in the upper aerodigestive tract of rats by scalpels result in the least postoperative weight loss, tissue destruction, and decrease in tensile strength, whereas wounds created by the KTP laser demonstrated a significantly greater postoperative weight loss, depth of wounding, and decrease in tensile strength.