Proceedings Article | 13 July 2004
KEYWORDS: Laser ablation, Ear, Surgery, Pulsed laser operation, Laser systems engineering, Tissues, Laser therapeutics, Er:YAG lasers, Femtosecond phenomena, Nd:YAG lasers
Introduction: Since the early 1980's, a considerable number of different laser systems have been introduced into reconstructive middle ear surgery. Depending on the ablation mode, however, pressure transients or thermal load to inner ear structures continue to be subject to discussion. Material and methods: We examined single spot ablations by a nanosecond-pulsed, frequency-tripled Nd:YAG-Laser (355 nm, beam diameter 10 μm, pulse rate 2 kHz, power 250 mW) on isolated human mallei. In a second set-up, a similar system (355 nm, beam diameter 20 μm, pulse rate 10 kHz, power 160-1500 mW) was coupled to a scanner to examine the morphology of bone surface ablation over an area of 1mm2. A third set-up employed a femtosecond-pulsed CrLiSAF-Oscillator (850 nm, pulse duration 100 fs, pulse energy 40μJ, beam diameter 36 μm, pulse rate 1 kHz) to compare these results with the former and with those obtained from a commercially available Er:YAG laser for ear surgery (Zeiss ORL E, 2940 nm, single pulse, energy 10-25 mJ). Results: In set-up 1 and 2, thermal effects in terms of marginal carbonization were visible in all single spot ablations of 1 s and longer. With ablations of 0.5 seconds, precise cutting margins with preservation of surrounding tissue could be observed. Cooling with saline solution resulted in no carbonization at 1500 mW and a scan speed of 500 mm/s. Set-up 3 equally showed no carbonization, although scanning times were longer and ablation less pronounced. Conclusion: Ultrashort pulsed laser systems could potentially aid further refinement of reconstructive microsurgery of the middle ear.
