[Effect of the pulsed Er:YSGG and Ho:YAG laser on the organ of Corti of the guinea pig cochlear--a scanning electron microscopy study].
BACKGROUND
Recent experimental studies have demonstrated that, apart from the continuous wave lasers, several pulsed laser systems are also suitable for stapedotomy. The aim of this study was to clarify whether irradiation of the basal convolution of the guinea pig cochlea could cause morphological inner-ear changes using the Er:YSGG and Ho:YAG laser with laser parameters required for stapedotomy.


METHODS
After opening the bulla, the basal convolution of the guinea pig cochlea, whose thickness is similar to that of the human stapes footplate, was irradiated with the Er:YSGG and Ho:YAG laser. The laser parameters used were those necessary for an adequate perforation of a human stapes footplate (500-600 microns). The cochleae were removed 90 minutes, 1 day, 2 weeks, or 4 weeks after laser application. The organ of Corti was examined by scanning electron microscopy in all convolutions.


RESULTS
Application of Er:YSGG laser parameters effective for stapedotomy (5 pulses, energy: 85 J/pulse, energy density: 36 J/cm2, total energy: 0.425 J) had no adverse effects on the organ of Corti in the guinea pig cochlea. On the other hand, effective Ho:YAG laser parameters (10 pulses, energy: 210 J/pulse, energy density: 90 J/cm2, total energy: 2.1 J) caused damage to the outer hair cells with fusion of stereocilia and formation of giant cilia leading to partial or total cell loss. The inner hair cells and supporting cells were usually normal.


CONCLUSIONS
Our results clearly demonstrate that the Er:YSGG laser has high application safety. It could prove to be a viable alternative to the thermically acting CO2 laser for stapedotomy. The Ho:YAG laser is not well tolerated in animals and has low application safety. Its use in stapedotomy would be unreliable and dangerous for the inner ear.
Hals-Nasen-Ohrenklinik mit Poliklinik im Klinikum Benjamin Franklin, Freien Universität Berlin.
Y
Y
Jamali
S
S
Jovanovic
U
U
Schönfeld
D
D
Anft
T
T
Ertl
H
H
Scherer
A
A
Berghaus
G
G
Müller
D000818:Animals; D003051:Cochlea / Q000293:injuries* / Q000473:pathology; D004869:Equipment Safety; D005260:Female; D006168:Guinea Pigs; D006198:Hair Cells, Auditory / Q000293:injuries / Q000473:pathology; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation*; D008855:Microscopy, Electron, Scanning; D013201:Stapes Surgery / Q000009:adverse effects / Q000295:instrumentation*