Capturing thermal, mechanical, and acoustic effects of the diode (980 nm) laser in stapedotomy.
BACKGROUND
The diode laser, with a wavelength of 980 nm, has promising characteristics for being used for the fenestration during stapedotomy. It is known that at this wavelength absorption in pigmented tissues is high, and absorption in water is relatively low compared with medical lasers in the infrared, making it theoretically an applicable laser for stapes surgery in patients with otosclerosis. Another important advantage is that, with respect to other lasers, this device is relatively inexpensive. Despite the potential advantages, the available literature only shows limited reports of this laser being used in stapes surgery. The present article evaluates the thermal, mechanical, and acoustic properties of the diode laser during stapes surgery.


METHODS
For the mechanical effects, high-speed imaging with a frame rate up to 4000 f/s (=250 μs resolution) was performed in an inner ear model. For thermal effects, the high-speed Schlieren technique was used. Acoustics were recorded by a hydrophone, incorporated in the model. Pulse settings were 100 ms, 3 W, which are the same settings used during stapes surgery.


RESULTS
The application of the diode laser resulted in limited mechanical and thermal effects. Impulse noise was low with an average of 52 (SD, 7.8) dB (A). Before carbonization of the tip of the delivery laser, fiber enhances ablation of the footplate.


CONCLUSIONS
The 980-nm diode laser is a useful tool for laser-assisted stapedotomy in patients with otosclerosis. Mechanical, thermal, and acoustic effects are limited and well within the safety limits.
*Department of Otorhinolaryngology, †Rudolf Magnus Institute of Neurosciences, ‡Department of Medical Technology and Clinical Physics, University Medical Center Utrecht, The Netherlands; and §Jean Causse Ear Clinic, Traverse de Béziers, Colombiers, France.
Digna M A
DM
Kamalski
Tjeerd
T
de Boorder
Arnold J N
AJ
Bittermann
Inge
I
Wegner
Robert
R
Vincent
Wilko
W
Grolman
D000162:Acoustics; D000180:Acrylic Resins; D007758:Ear, Inner / Q000601:surgery; D005276:Fenestration, Labyrinth / Q000295:instrumentation; D005782:Gels; D006801:Humans; D054023:Lasers, Semiconductor; D008953:Models, Anatomic; D010040:Otosclerosis / Q000601:surgery*; D010969:Plastics; D013201:Stapes Surgery / Q000295:instrumentation*; D013314:Stress, Mechanical; D013816:Thermodynamics; D000099166:Polyacrylamides
D000180:Acrylic Resins; D005782:Gels; D010969:Plastics; D000099166:Polyacrylamides