Laser Applications in Ossicular Surgery

McGee, T. Manford

doi:10.1016/s0030-6665(20)31313-x

Cited by 15 publications

(10 citation statements)

References 5 publications

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“…7,23,24 The advantages of KTP and argon lasers in revision stapes and tympanoplasty surgery have already been observed by several authors, especially in relation to the removal of dislocated or xed implants. 1,17,19 There is still surprisingly little data available on the interaction between visible-spectrum lasers and the new types of ossicular prostheses.…”

Section: Discussionmentioning

confidence: 99%

“…During the past few years several authors have suggested that KTP and argon lasers are ideal tools for removing and changing previously used prostheses in revision stapes and tympanoplasty operations, as the vaporization of the granulation tissue around the prostheses and the cutting of the scars can be carried out without any manipulation of the ossicles, minimizing the risk of iatrogenic injury to the cochlea. [17][18][19] The aim of the present study was to investigate the interaction between the KTP 532 Orion laser and the individual implants.…”

Section: -16mentioning

confidence: 99%

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Effect of KTP laser on implants used in middle-ear surgery

et al. 2002

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The present study is intended to explore the effects of the KTP laser on various types of implant, used in middle-ear surgery. A laboratory study was undertaken to evaluate the interaction between the KTP laser (KTP-532 Orion Laser, Laserscope, UK) and individual middle-ear implants. A variety of middle-ear implants were used: a silicone sheet, Teflon, hydroxylapatite, ionomeric cement, gold and titanium prostheses as well as gelfoam. Following exposure to the laser, these implants were studied by direct inspection using an operating microscope. The KTP laser induced no detectable alteration in any of the implants when they were clean and dry. However, in the presence of fresh blood, under the influence of the energy of the absorbed laser, the silicone burnt and melted and the Teflon piston was vaporized. Likewise, a few tiny holes appeared on the surface of the ionomeric implant and then the prosthesis deformed. The hydroxylapatite implant broke into two pieces. However, no detectable alteration could be observed on gold or titanium pistons, even in the presence of blood. The authors conclude, that in the presence of blood, interaction between the KTP laser and both silicone and hydroxylapatite implants needs to be avoided. Teflon prostheses can be cautiously vaporized. Gold and titanium prostheses were unaffected by laser even in the presence of blood.

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Section: Discussionmentioning

confidence: 99%

Section: -16mentioning

confidence: 99%

Effect of KTP laser on implants used in middle-ear surgery

et al. 2002

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“…It is useful to remove the microscopic squama that might remain after a mastoidectomy procedure. 2 A laser also can control the microbleeding on the sheath of the facial nerve. Also, stapedotomy has been performed with a laser.…”

Section: Discussionmentioning

confidence: 99%

“…The laser has been used as a tool in microsurgery of the ear since 1980, and acceptable results have been reported in surgery of chronic ear diseases and otosclerosis. [1][2][3] Generally, the use of a laser in otology has been focused on the destructive procedures, such as vaporization and cutting of soft tissues and bone.…”

mentioning

confidence: 99%

Laser Soldering and Welding for Ossicular Reconstruction: An in Vitro Test

Park

Min

2000

Otolaryngol.--head neck surg.

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To evaluate the possibility of laser application in ossicular reconstruction, soldering and welding of bony tissue with proteineous materials was performed by using a Co2 laser, and the bonding strength of these materials was measured with a gradual weighing system. The soldered and welded surface of bone was observed with a scanning electron microscope. Additionally, welding of human ossicles and synthetic materials was experimentally tried with lasers, and morphologic changes were observed and recorded. A scanning electron microscopic examination was also done. A 40% albumin solution and commercial fibrin glue showed the best bonding strength. Bridging of denatured protein solder may be a mechanism of bonding. Polycel was melted by using a laser beam, and melted Polycel covered the surface of the ossicle. However, the bonding strength was not enough to use, and exact measurement of bonding strength was not possible. These results suggested the possibility of laser soldering and welding in ossicular reconstruction, especially with ossicle or cortical bone.

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“…Perkins [ 3 ] was the first to perform a stapedectomy using the argon laser, although the footplate of the stapes was only partially ablated; after having been reduced in thickness by the laser, the footplate underwent further mechanical fracturing. In the following years there were reports of numerous successful operations with good audiological results, for example, from Di Bartolomeo and Ellis [ 4 ], McGee [ 5 ], Silverstein et al [ 6 ], and Lesinski and Palmer [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Pressure and Temperature Changes inIn VitroApplications with the Laser and Their Implications for Middle Ear Surgery

Schwab

Kontorinis

2010

International Journal of Otolaryngology

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Background. The purpose of this study was to evaluate the thermal and pressure effects using a Titan Sapphire chirped-pulse amplifier system configured to deliver ultrashort pulses of 180 femtoseconds (fs) in an inner ear model. Materials and Methods. Temperature increases and heat exchange processes in the fluid (physiological saline) were examined in a calorically and physiologically approximated cochlea model for applying laser parameters effective in the creation of footplate perforations. Results. In the effective energy density range, the highest temperature increases achieved with the Carbon dioxide (CO2) laser were about 11 degrees C. The lowest temperature maxima were 6 degrees C with the Er:YAG laser (Yttrium-Aluminum-Oxide doted with Erbium3+-ions) and <5 degrees C with the femtosecond laser. Comparison of the laser-induced pressure with the limit graph published by Pfander indicated that the use of the fs laser is unobjectionable for fluences <1 J/cm2. Conclusions. Our investigations demonstrated that the application of the fs laser in middle ear surgery presents a new and promising addition to the range of ultrashort wavelength lasers used for this purpose.

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Laser Applications in Ossicular Surgery

Cited by 15 publications

References 5 publications

Effect of KTP laser on implants used in middle-ear surgery

Effect of KTP laser on implants used in middle-ear surgery

Laser Soldering and Welding for Ossicular Reconstruction: An in Vitro Test

Pressure and Temperature Changes inIn VitroApplications with the Laser and Their Implications for Middle Ear Surgery

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