PubMed · 5241356
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G Ripp. 1968. Rhinolith.. https://doi.org/10.1016/0030-4220(68)90221-1
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PURPOSE: The mechanism of lithotripsy differs among electrohydraulic lithotripsy, mechanical lithotripsy, pulsed dye lasers and holmium:YAG lithotripsy. It is postulated that fragment size from each of these lithotrites might also differ. This study tests the hypothesis that holmium:YAG lithotripsy yields the smallest fragments among these lithotrites. MATERIALS AND METHODS: We tested 3F electrohydraulic lithotripsy, 2 mm. mechanical lithotripsy, 320 microns pulsed dye lasers and 365 microns. holmium:YAG fiber on stones composed of calcium hydrogen phosphate dihydrate, calcium oxalate monohydrate, cystine, magnesium ammonium phosphate and uric acid. Fragments were dessicated and sorted by size. Fragment size distribution was compared among lithotrites for each composition. RESULTS: Holmium:YAG fragments were significantly smaller on average than fragments from the other lithotrites for all compositions. There were no holmium:YAG fragments greater than 4 mm., whereas there were for the other lithotrites. Holmium:YAG had significantly greater weight of fragments less than 1 mm. compared to the other lithotrites. CONCLUSIONS: Holmium:YAG yields smaller fragments compared to electrohydraulic lithotripsy, mechanical lithotripsy or pulsed dye lasers. These findings imply that fragments from holmium:YAG lithotripsy are more likely to pass without problem compared to the other lithotrites. Furthermore, the significant difference in fragment size adds evidence that holmium:YAG lithotripsy involves vaporization.
A 9-year-old boy presented with a painless hard tumor in the right lower lid. It had grown slowly since 12 months. Three months before presentation cryotherapy was administered by a dermatologist because of a presumed wart. Both eyes were normal. Clinical differential diagnosis included a keratoakanthoma and a wart. Excisional biopsy was performed. Histology revealed granular deposits which stained positive with hematoxylin-eosin and von Kossa stain. Though a secondary (dystrophic) calcinosis of the lid following cryotherapy could not be ruled out a diagnosis of an idiopathic subepidermal calcified nodule (calculus) of the lid was established.