Sialolithiasis: Application parameters for an optimal laser therapy

In‐vitro experimental parametric studies of laser ablation using natural sialoliths and artificial stones have been performed toward an efficient laser treatment of sialolithiasis. Surface microstructure and water adsorption become critical for coupling high power pulsed Ho:YAG laser radiation (λ = 2080 nm, τ ∼250 μsec), inducing ablative interactions and stone fragmentation. Results reveal a generic trend, with single pulse laser energy density threshold for sialolith ablative erosion at ∼200 J cm−2 (corresponding to intensity ∼800 kW cm−2) and fragmentation rates reaching ∼1 mm/pulse at ∼2400 J cm−2. This process shows no saturation, suggesting that very high energy density irradiation at low pulse repetition rate is an efficient approach. Such operation facilitates rapid cooling and minimal thermal loading of the oral and maxillofacial area, thus causing negligible adverse effects. The method is expected to contribute to the establishment of an easy and optimal therapeutic protocol for sialolithiasis pathology. Endoscopic laser lithotripsy is preferred to surgical therapy of sialolithiasis pathology. The plethora of diverse conditions applied in current practice hinder the formulation of efficient methodologies. The present investigation focuses on the physical parameters for the effective ablative fragmentation of sialoliths. In contrast to the usually applied multi‐pulse laser irradiation, the results recommend that single and high‐energy density laser pulses are capable to conclude an optimal therapy minimizing adverse effects.