Holmium:YAG laser stapedotomy: preliminary evaluation

Ingrid M. Stubig; Paul A. Reder M.D.; G. W. Facer M.D.; Henry Grady Rylander; Ashley J. Welch

doi:10.1117/12.147017

1 July 1993 Holmium:YAG laser stapedotomy: preliminary evaluation

Ingrid M. Stubig, Paul A. Reder M.D., G. W. Facer M.D., Henry Grady Rylander, Ashley J. Welch

Proceedings Volume 1876, Lasers in Otolaryngology, Dermatology, and Tissue Welding; (1993) https://doi.org/10.1117/12.147017
Event: OE/LASE'93: Optics, Electro-Optics, and Laser Applications in Scienceand Engineering, 1993, Los Angeles, CA, United States

Abstract

This study investigated the use of a pulsed Holmium:YAG ((lambda) equals 2.09 micrometers ) laser- fiber microsurgical system for laser stapedotomy. This system ablates human stapes bones effectively with minimal thermal damage. The study was designed to determine the effectiveness of the Ho:YAG laser (Schwartz Electro Optics, Inc., Orlando, FL) for stapedotomy and to evaluate temperature changes within the cochlea during the ablation process. Human cadaveric temporal bones were obtained and the stapes portion of the ossicular chain was removed. A 200 micrometers diameter low OH quartz fiber was used to irradiate these stapes bones in an air environment. The laser was pulsed at 2 Hz, 250 microsecond(s) ec pulse width and an irradiance range of 100 - 240 J/cm² was used to ablate holes in the stapes footplate. The resultant stapedotomies created had smooth 300 micrometers diameter holes with a minimum of circumferential charring. Animal studies in-vivo were carried out in chinchillas to determine the caloric spread within the cochlea. A 0.075 mm Type T thermocouple was placed in the round window. Average temperature change during irradiation of the stapes footplate recorded in the round window was 3.6 degree(s)C. The data suggest that stapedotomy using the Ho:YAG laser can result in a controlled ablation of the stapes footplate with minimal thermal damage to the surrounding stapes. Optical coupling using fiberoptic silica fibers is an ideal method for delivering laser energy to the stapes during stapedotomy.

Citation Download Citation

Ingrid M. Stubig, Paul A. Reder M.D., G. W. Facer M.D., Henry Grady Rylander, and Ashley J. Welch "Holmium:YAG laser stapedotomy: preliminary evaluation", Proc. SPIE 1876, Lasers in Otolaryngology, Dermatology, and Tissue Welding, (1 July 1993); https://doi.org/10.1117/12.147017

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