Premium
Flexible fiberoptic endoscopy and laser surgery in obliterated cochleas: Human temporal bone studies
Author(s) -
Kautzky Michael,
Susani Martin,
Franz Peter,
Zrunek Michael
Publication year - 1996
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/(sici)1096-9101(1996)18:3<271::aid-lsm9>3.0.co;2-p
Subject(s) - photoablation , medicine , endoscopy , temporal bone , cochlea , anatomy , surgery , laser surgery , laser , physics , excimer laser , optics
Background and Objective The use of conventional drilling procedures in cochlear implant surgery of ossified cochleae poses special risks to the facial nerve and the carotid artery. This study evaluated the alternate use of flexible fiberoptic endoscopy and mid‐infrared laser surgery for recanalization of partially and artificially obliterated cochleae in freshly dissected human cadavers. Study Design/Materials and Methods A pulsed Holmium:YAG‐laser (λ = 2120 nm) was used in the free‐running mode (1180 mJ, 250 μs pulse, 5 Hz). A 660 μm optic quartz fiber was positioned in the center of the round window niche and slowly—endoscopically guided—advanced in contact shooting over 1.5 cm, creating by vaporization and photoablation a passage through the artificial bony occlusion in the basal segment of the cochlea. Results In all experiments, laser application (110–130 pulses) resulted in complete recanalization of the bony occlusions without damaging surrounding structures. The microendoscopy proved capable of guiding the laser fiber through the curved segment of the basal turn allowing identification of normal bone, bone cement, and laser‐treated bone cement. Conclusion If partial ossification of the basal turn is present, this technique could give access to place analog as well as digital implants deep within the cochlea. © 1996 Wiley‐Liss, Inc.