Dong-Dong Ren1, Fang-Lu Chi. 1. Department of Otology & Skull Base Surgery, Eye & ENT Hospital, Fudan University, Shanghai, PR China.
Abstract
BACKGROUND AND OBJECTIVE: Surgery of the inner ear requires atraumatic techniques to preserve the morphology of the inner ear. Recent experiment and clinical studies have demonstrated that several laser systems are suitable for cochleostomy. The goal of this study was to quantify the thermic effects, morphology and function of guinea pig cochlea in vivo by comparing the erbium:yttrium-aluminum-garnet (Er:YAG) laser and carbon dioxide (CO(2)) laser and to determine the optimum laser parameters for safe clinical treatment. STUDY DESIGN/ MATERIALS AND METHODS: A fenestration in the basal cochlear turn of guinea pigs was created. A type K thermocouple was placed on the membrane of round window to detect the local temperature change during laser irradiation. The auditory evoked brainstem response (ABR) was measured before and after laser application. Confocal laser microscopy and scanning electron microscopy (SEM) was used for cochlear morphology. RESULTS: An increased hearing loss immediately and 4 weeks later after irradiation was observed in animals with the higher power CO(2) laser in accordance with a higher temperature increase during laser application. In contrast, a wider safety scope of Er:YAG application in cochleostomy was presented with little temperature increase. These findings were correlated with the ultrastructural changes in guinea pig cochlea. CONCLUSION: The Er:YAG and CO(2) lasers are shown to be safe if the total amount of energy is kept within the limits applied in this study. In addition, on this preliminary basis by guinea pig laser cochleostomy, Er:YAG laser maybe less damaging to inner ear structures than CO(2) laser with a larger safety scope and less thermic effects. (c) 2008 Wiley-Liss, Inc.
BACKGROUND AND OBJECTIVE: Surgery of the inner ear requires atraumatic techniques to preserve the morphology of the inner ear. Recent experiment and clinical studies have demonstrated that several laser systems are suitable for cochleostomy. The goal of this study was to quantify the thermic effects, morphology and function of guinea pig cochlea in vivo by comparing the erbium:yttrium-aluminum-garnet (Er:YAG) laser and carbon dioxide (CO(2)) laser and to determine the optimum laser parameters for safe clinical treatment. STUDY DESIGN/ MATERIALS AND METHODS: A fenestration in the basal cochlear turn of guinea pigs was created. A type K thermocouple was placed on the membrane of round window to detect the local temperature change during laser irradiation. The auditory evoked brainstem response (ABR) was measured before and after laser application. Confocal laser microscopy and scanning electron microscopy (SEM) was used for cochlear morphology. RESULTS: An increased hearing loss immediately and 4 weeks later after irradiation was observed in animals with the higher power CO(2) laser in accordance with a higher temperature increase during laser application. In contrast, a wider safety scope of Er:YAG application in cochleostomy was presented with little temperature increase. These findings were correlated with the ultrastructural changes in guinea pig cochlea. CONCLUSION: The Er:YAG and CO(2) lasers are shown to be safe if the total amount of energy is kept within the limits applied in this study. In addition, on this preliminary basis by guinea pig laser cochleostomy, Er:YAG laser maybe less damaging to inner ear structures than CO(2) laser with a larger safety scope and less thermic effects. (c) 2008 Wiley-Liss, Inc.