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In vivo laser cartilage reshaping with carbon dioxide spray cooling in a rabbit ear model: A pilot study
Author(s) -
Kuan Edward C.,
Hamamoto Ashley A.,
Sun Victor,
Nguyen Tony,
Manuel Cyrus T.,
Protsenko Dmitry E.,
Wong Brian J. F.,
Nelson J. Stuart,
Jia Wangcun
Publication year - 2014
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/lsm.22305
Subject(s) - cartilage , materials science , irradiation , in vivo , biomedical engineering , laser safety , auricle , population , laser , medicine , surgery , anatomy , optics , biology , physics , microbiology and biotechnology , environmental health , nuclear physics
Background/Objectives Similar to conventional cryogen spray cooling, carbon dioxide (CO 2 ) spray may be used in combination with laser cartilage reshaping (LCR) to produce cartilage shape change while minimizing cutaneous thermal injury. Recent ex vivo evaluation of LCR with CO 2 cooling in a rabbit model has identified a promising initial parameter space for in vivo safety and efficacy evaluation. This pilot study aimed to evaluate shape change and cutaneous injury following LCR with CO 2 cooling in 5 live rabbits. Study Design/Materials and Methods The midportion of live rabbit ears were irradiated with a 1.45 µm wavelength diode laser (12 J/cm 2 ) with simultaneous CO 2 spray cooling (85 millisecond duration, 4 alternating heating/cooling cycles per site, 5 to 6 irradiation sites per row for 3 rows per ear). Experimental and control ears (no LCR) were splinted in the flexed position for 30 days following exposure. A total of 5 ears each were allocated to the experimental and control groups. Results Shape change was observed in all irradiated ears (mean 70 ± 3°), which was statistically different from control (mean 37 ± 11°, P = 0.009). No significant thermal cutaneous injury was observed, with preservation of the full thickness of skin, microvasculature, and adnexal structures. Confocal microscopy and histology demonstrated an intact and viable chondrocyte population surrounding irradiated sites. Conclusions LCR with CO 2 spray cooling can produce clinically significant shape change in the rabbit auricle while minimizing thermal cutaneous and cartilaginous injury and frostbite. This pilot study lends support for the potential use of CO 2 spray as an adjunct to existing thermal‐based cartilage reshaping modalities. An in vivo systematic evaluation of optimal laser dosimetry and cooling parameters is required. Lasers Surg. Med. 46:791–795, 2014. © 2014 Wiley Periodicals, Inc.