Laser-assisted cerebrospinal fluid leak repair: an animal model to test feasibility.
OBJECTIVE
To test the feasibility of laser tissue welding as a method of creating an endonasal tissue bond for the purpose of cerebrospinal fluid leak repair.


METHODS
An 808 nm diode laser was used with a 42% albumin solder to create laser welds in sheep nasal septal mucosa, periosteum, and in situ rabbit maxillary sinus mucosa. Each condition was tested five times. Groups were compared with Kruskal-Wallis nonparametric analysis of variance (ANOVA) and post-hoc multiple-comparisons testing with the Bonferroni test.


RESULTS
The burst pressures of sheep septal mucosa (34.88 +/- 3.49 mmHg) and periosteum (30.02 +/- 2.23 mmHg) were significantly higher than suture repair. A burst pressure of 69.58 +/- 2.85 mmHg was achieved in rabbit in situ maxillary sinus mucosa.


CONCLUSIONS
Laser welding is capable of producing tissue bonds whose burst strength exceeds that of human intracranial pressure.


CONCLUSIONS
This is the first study to examine the feasibility of laser tissue welding in endonasal tissues. The ability to produce instant transnasal tissue bonds with burst pressures that exceed human intracranial pressure make this technology ideal for cerebrospinal fluid leak repair.
Bleier
Benjamin S
BS
Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104-4206, USA. benjamin.bleier@uphs.upenn.edu
Palmer
James N
JN
Sparano
Anthony M
AM
Cohen
Noam A
NA
D000818:Animals; D002559:Cerebrospinal Fluid Rhinorrhea / Q000601:surgery*; D005240:Feasibility Studies; D053685:Laser Therapy / Q000379:methods*; D009297:Nasal Mucosa / Q000502:physiology; D011817:Rabbits; D012756:Sheep