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

Abstract

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.

Experimental study on heat transmission to the vestibule during CO2 laser use in revision stapes surgery

“…The effect of laser energy on the piston is important and may influence the choice of surgical technique. Gerlinger et al 4 laser on different types of prostheses. Hydroxylapatite prostheses shattered when exposed to KTP laser energy.…”

“…Wanamaker and Silverstein 3 and, more recently, Gerlinger et al 4 have examined the effect of the potassium-titanyl-phosphate (KTP) laser on middleear implants. Both studies showed that the KTP laser may damage fluoroplastic pistons, especially when blood was added to the surface of the piston.…”

Silicon Implant in Middle Ear Reconstruction

“…Use of silicon implants in ossiculoplasty is rarely reported despite their enormous prospects [4]. The present study is an attempt to evaluate the feasibility, increase in hearing sensitivity, extrusion rate and cost effectiveness of silicon implants in middle ear reconstruction surgeries.…”

Transmission of heat to the vestibule during revision stapes surgery using a KTP laser: an in vitro study

“…This may result in inadvertent laser hits on the prosthesis. Wannamaker and Silverstein 4 and Gerlinger et al 5 have studied the effect of KTP lasers on various materials and prostheses used in middle-ear surgery and Wannamaker and Silverstein 4 also examined the effects of the argon laser. Both groups reported that little damage occurred to stapes pistons unless blood was present on their surfaces.…”

“…Gerlinger et al 5 suggested that heat might be transmitted to the vestibule when a piston is hit by a laser pulse or pulses and that this might have undesirable effects. This would depend on the resultant temperature change.…”