Effects of continuous‐wave laser systems on stapes footplate

Abstract

Background und Objective: The aim of the present study was to clarify which of the presently available continuous-wave laser systems are best suited for application in stapes surgery. Study DesignlMuterhZs and Methods: Isolated human stapes and bovine compact-bone platelets were used to investigate the connections between the parameters of various laser systems and their effects on bone tissue. The purpose was to optimize the laser parameters required to achieve a perforation measuring 500 pm to 600 pm in diameter. Three different laser systems were applied: the argon and COz laser in continuous wave (cw) mode and the COz laser in superpulse mode. Results: The suitability of the argon laser for stapedotomy is doubtful in view of the lower absorption coefficient of the stapes for the argon beam and the considerable influence which the degree of pigmentation of the irradiated medium exerts on its effect with the resultant poor reproducibility of the perforation diameter. The beam of the CO, laser is far better absorbed at the footplate than that of the argon laser. This results in higher effectivity, lower thermic side effects, and better reproducibility of the perforation. The two modes of the CO, laser do not show any appreciable differences. Conclusion.-The experimental results presented indicate that the C02 laser in cw and superpulse mode is the most suitable of the systems now clinically applied in stapes surgery. 0 1996 Wiley-Liss, Inc.

CO2 laser revision stapedotomy

“…During vaporization of connective tissue in the oval niche or direct irradiation of the prosthesis, heat may be conducted to the vestibulum if the piston is still in the stapedotomy opening. However, in previous studies, we and others have experimentally determined and demonstrated safe parameters for the CO 2 laser application in animals and humans …”

CO2 Laser Stapedotomy with the “One‐Shot” Technique— Clinical Results

“…13 The total energy minimization required to prevent inner ear damage is best achieved by the single application of a focussed laser beam. [12][13][14] The laser industry (Lumenis Co., Tel Aviv, Israel) cooperated in the development of microprocessor-controlled scanner systems that move the focussed laser beam over a defined and selectable area in short time intervals with the aid of rotating mirrors. These systems are the first to achieve a perforation large enough for a piston by applying the laser a few times or only once.…”

Knochenablation mittels ultrakurzer Laserpulse. Eine neue Technik für die Mittelohrchirurgie

“…So fanden Wong et al [23] bei einer Oberflächenanalyse nach Laserbeschuss durch Argon-, cwCO 2 -, und KTP-Laser deutliche Koagulationseffekte, Schmelzzonen an den Kraterrändern und Risse durch explosive Gaseruptionen. Untersuchungen von Jovanovic et al [9,17,22,24] ganischer Substanzen mit anschlieûender eruptiver Freisetzung organischer und anorganischer Knochensubstanz zuschreibt.…”