Abstract
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.
Highlights
Since the first stapedectomies were carried out by Shea in the late 1950s [1], otosclerosis surgery has become a routine procedure
In the effective energy density range, the highest temperature increases achieved with the Carbon dioxide (CO2 ) laser were about 11 degrees C
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
Summary
Since the first stapedectomies were carried out by Shea in the late 1950s [1], otosclerosis surgery has become a routine procedure. 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] Thermal laser systems such as argon, carbon dioxide (CO2 ), and KTP (potassium titanium oxide phosphate) laser have been dominant in stapes surgery up to now; it is precisely the thermal stress and the associated potential for damage to the inner ear structures [8,9,10] or the facial nerve [11, 12] that are a property of these systems.
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