Pixel CO2 for ENT Procedures THE POWER OF. Precision

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Pixel CO2 for ENT Procedures THE POWER OF Precision Laryngology Bronchoscopy Phrenology Snoring Tonsillectomy Oral Surgery Otology Turbinectomy Nasal Cavity Head & Neck

ENTelligence brings unparalleled precision and innovation to the fields of surgical otolaryngology and oral surgery. Alma s CO2 laser offers the ability to perform minimally invasive, highly precise surgery suitable for a wide range of treatments for conditions of the ear, nose and throat as well as of the oral cavity. Supporting a wide variety of applications, accessories and surgical tools, and adaptable to most surgical microscopes, Alma Pixel CO2 optimizes treatment results and opens the door to new possibilities in minimally invasive surgical care. EXTENDING SURGICAL PERFORMANCE Multiple ENT and oral indications Reduced treatment time Layer-with-layer ablation by LiteScan Surgical precision Minimally invasive Safe for delicate areas 2 ENTelligence - Pixel CO 2 for ENT

Alma Pixel CO 2 The Alma Surgical Pixel CO2 system features advanced computerized precision CO2 laser technology for ENT and oral surgical applications. Using light energy emitted by a carbon dioxide laser, the Pixel CO2 laser achieves char-free tissue ablation, vaporization, incision, excision and coagulation of soft tissue. With layer-by-layer ablation and variable depth penetration, the system offers high surgical precision and treatment control, maximizing treatment efficiency and minimizing tissue damage. Supporting Pixel CO2 laser accessories and scanning devices extend surgical performance and flexibility, allowing surgeons to access and treat complex, delicate anatomical structures. ENTelligence - Pixel CO 2 for ENT 3

Cut & Coagulate with Perfect Control The CO 2 laser is well-known for its versatility and safety benefits in surgical applications due to its precise depth of penetration, reduced lateral thermal effect, and excellent coagulation effect. Harnessing these benefits for the treatment of delicate areas, Alma Pixel CO 2 combines cutting and coagulation into a single setting. The two modes work synergistically, allowing physicians to perform both actions without having to switch accessories during procedures. In cut (ablation) mode, the pulse emits high peak power, causing immediate ablation of tissue up to the epidermisdermis junction. In coagulation (thermal) mode, the pulse emits modest power and longer pulse duration, conducting heat beyond the epidermis-dermis junction, causing blood vessels and tissue to shrink. This dual action pulse allows surgeons to achieve optimal results with faster treatment times, minimal bleeding and reduced patient downtime. Surgeons may select from two modes of laser delivery, depending on the procedure. Repeat Mode (default): produces short pulses of high laser energy. This mode is effective for cutting and vaporizing tissue. Pulse Mode (single pulse ): produces a single pulse of laser energy, for slower, more supervised energy delivery. 4 ENTelligence - Pixel CO 2 for ENT

Benefits Precise surgery Bloodless dissection Minimal instrumentation Char-free precise scanner ablation Quicker recovery & less pain Minimal damage to adjacent normal tissues Smart, User-friendly interface The Alma Pixel CO2 is designed with smart, userfriendly features and quick set-up capabilities. A touch screen LCD display provides step-by-step operating instructions and indicates correct accessories and scanning patterns for each treatment objective. The system optimizes procedures by offering pre-set operation and laser delivery parameters and allows users to configure custom parameters and patterns of injury (ablative vs. fractional ablative) for specific indications. These settings may also be saved for future procedures. W Power New Blended Cut & Coagulate Mode T Time Coagulate Pulse Cut Pulse ENTelligence - Pixel CO 2 for ENT 5

Indications Laryngeal Microsurgery: + Polyps and laryngeal papilloma + Vocal cord nodules and polyps + Benign neoformations + Hyperkeratosis laryngitis + Scar tissue + Granulomas + Leukoplachia and erythroplasia + Primary laryngeal tumors + Laryngotracheal stenosis Otology: + Benign and cancerous lesions on the external ear + Myringotomy + Tympanic membrane + Otosclerosis Oral Surgery: + Leukoplachias + Erythroplasias + Papillomas + Hemangiomas + Benign & malignant lesions + Snoring + Choanal atresia + Tonsillotomy & tonsillectomy + Tonsil ablation + Frenectomy + Halitosis Nasal, Endonasal & Endoscopic Sinus Surgery: + Turbinate hyperplasia + Removal of nasal obstructions (e.g. stenosis) + Recurrent nasal polyps and cysts + Rhinophyma + Cheloids and hypertrophic scars Head & Neck: + Resection of benign and cancerous tumors in sub-facial and neck areas 6 ENTelligence - Pixel CO 2 for ENT

Delivery Systems LiteScan The LiteScan surgical scanner is a handheld microprocessor-controlled laser flash scanner, designed for use in a variety of ENT and oral applications. It optimizes procedure efficiency by automatically setting the laser beam parameters required for each indication. In addition to char-free superficial ablation and vaporization, the system may also be used for incision or excision of tissue. LiteScan offers full control of laser dwell time, shape patterns and power density at every point of the treatment area, maximizing physician control over patient outcome. It is ideal for tonsil ablation through scanning, partial tonsillectomy, and when combined with the 200mm oral probe, oral cavity treatments. Surgical 100mm/50mm/200mm Focusing Applicators Fixed focus applicator of varying focal distances and spot sizes allow for precise and accurate soft tissue cutting: Focal distance 50mm 100mm 200mm with focus/defocus Spot size 0.125mm 0.20mm 400 micron ENTelligence Accessories Nasal Kit- with a special optics set consisting of: + 120º attachment (150mm) + 90o attachment (80, 150mm) + 0o attachment (150mm) + Brush for attachments 50/100 mm applicator 200 mm applicator ENTelligence - Pixel CO 2 for ENT 7

Delivery Systems TruSpot Micromanipulator + CVD + Scanner Alma s TruSpot micromanipulator features an integrated high-accuracy scanner that allows for precise CO2 laser surgery under direct microscopic guidance. TruSpot incorporates a Continuously Variable Defocus (CVD) optical system for adjusting the spot size, and a joystick for controlling the laser beam position at the target site. The micromanipulator is designed to obtain significantly smaller laser beam spot sizes (200-300 microns) for precise microsurgery at various working distances. The TruSpot achromatic and coaxial laser beam brings high quality of accuracy to its perfection. The ability to use lower laser powers and the quick laser energy delivery mechanism allow for char-free tissue ablation and predictable, repeatable vaporization at a microscopic level. TruSpot offers full control of laser dwell time, scanning/shape patterns and power density at every point of the treatment area, maximizing physician control over patient outcome. It is ideal for use with procedures requiring microscopic precision, including treatment of Larynx and Oral indications. TruSpot Technical Specifications Mirror-based, achromatic confocal. Fully coaxial with microscope optical axis. Working Distance 200mm 250mm 300mm 350mm 400mm Spot Size 0.16 to 2.8mm 0.19 to 3.2mm 0.21 to 3.7mm 0.24 to 4.1mm 0.27 to 4.6mm Oral Accessories VSS (Variable Spot Size) 1-4mm applicator: Allow physician to manually change the spot size during the procedure without interrupting treatment. Oral Pharyngeal Kit - 200mm applicator, including Backstop and Straight tips. VSS applicator 8 ENTelligence - Pixel CO 2 for ENT

Alma Pixel CO2 Technical Specifications Output Laser Type Laser Type Sealed-off, RH-excited CO 2 laser 10,600 nm, infared CW (Continuous Wave) Mode Laser Output Power Up to 30 watts (30W model system) Up to 40 watts (40W model system) Up to 70 watts (70W model system) Modes of Operation Continuous, Pulse, Repeat and Super Pulse Modes Scanners Litescan TruSpot Working distance (CVD) Scanner applicator Mechanical joystick control Micro manipulator 200-450 mm Surgical Focusing applicator Focal Distances 50/100/200mm ENTelligence - Pixel CO 2 for ENT 9

ENTelligence Fibers and Accessories Flexible CO 2 Fibers Alma Pixel CO2 features flexible laser fibers for maximum versatility, durability and performance. The fibers flexibility allows surgeons to easily access difficult-to-reach anatomy while an aiming beam offers maximum visualization. High energy transmission along the flexible laser fiber allows surgeons to treats tissue faster- reducing treatment time, while achieving superior surgical precision. Technical Parameters Features + Available in many angulations (90 v, 20 v, 0 v ) + Enhanced accessibility: straight, left, right beam output + Precision 0.8mm spot facilitates exact cutting, ablation and vaporization with minimal thermal transfer to delicate surrounding tissues + Available with or without smoke evacuation (nasal probes) + Stainless steel pre-formed sheath accepts multi-use FiberLase core, which transmits a red aiming beam for precise placement of the active beam. + Nasal probe length: approximately 120mm + Laryngeal probe length: approximately 190mm + Probes require air/inert gas flow 10 ENTelligence - Pixel CO 2 for ENT

Benefits Precise surgery Bloodless dissection Minimal instrumentation Char-Free precise Scanner ablation Quicker recovery & less pain Minimal damage to adjacent normal tissues Alma Pixel CO2 Features Aiming beam Low beam divergence Flexible 2 meter CO 2 fiber, up to 20 watt Fiber support guide & applicator support arm Optional internal purge air supply 2 fiber connection options: Fiber connected to the articulated arm, and fiber instead of articulated arm ENTelligence - Pixel CO 2 for ENT 11

Alma Surgical is the new standard in pioneering, smart laser solutions, and the bridge to highly specialized outpatient medical care. From gynecology, urology and phlebology to plastic surgery and dermatology, the company s minimally invasive laser solutions provide superior results and reduced treatment time for safer and more efficient practice and patient care. Alma Surgical is a division of Alma Lasers, a global innovator of laser, light-based, radiofrequency and ultrasound solutions for the medical aesthetic and surgical markets. Alma Lasers GmbH Nordostpark 100-102 90411 Nuremberg, Germany Tel. + 49 911 89 11 29 0 Fax + 49 911 89 11 29 99 contact@almasurgical.com www.almalasers.com 2018 Alma Lasers, All rights reserved. Alma Lasers, its logo, and Pixel CO2 are trademarks or registered trademarks of Alma Lasers, LiteScan and TruSpot in the United States and/or other countries. Product specifications are subject to change without notice. CONNECT WITH ALMA LASERS PBEN05091601_01