Penetration of CO2 laser into the otic capsule using a hand-held, flexible-fiber delivery system. 2009

Omid Majdani, and Justin Wittkopf, and Mary S Dietrich, and Robert F Labadie
Department of Otolaryngology, Medical University of Hannover, Hannover 30659, Germany.

OBJECTIVE Recently, a new, flexible-fiber, CO2 laser delivery system has been FDA-cleared for clinical use. However, for otologic surgery, no data have been reported correlating power settings to depth of penetration into the otic capsule-the bone that covers the inner ear. This was the goal of our study. METHODS Eight cadaveric temporal bones were procured as per our institution's protocols. For each specimen, nine different laser holes were burned into the otic capsule using the flexible-fiber CO2 laser delivery system. Power settings were varied from 10 to 20 W in 2 W increments, and duration of exposure was 100, 200, 300, 400, or 600 milliseconds. Each setting (power and duration) was tested on two specimens. Following laser exposure, each specimen was scanned in a microCT scanner, and the depth of penetration measured from these images. RESULTS Of the 72 laser shots, 8 were excluded due to double hits (4), oblique hits (3), or complete penetration (1). After excluding these 8, bone penetration was found to vary from 160 to 670 microm based on power and time settings. Spearman analysis on ranked data showed that time had a greater impact on depth than power. The correlation coefficients for time and power were 0.84 (P = 0.013) and 0.40 (P<0.001), respectively. CONCLUSIONS The flexible-fiber CO2 laser is effective for otic capsule ablation in this model. High power setting and long pulse duration can lead to complete penetration of the otic capsule potentially causing damage of underlying structures such as the facial nerve, horizontal semicircular canal, and cochlea.

UI MeSH Term Description Entries
D007758 Ear, Inner The essential part of the hearing organ consists of two labyrinthine compartments: the bony labyrinthine and the membranous labyrinth. The bony labyrinth is a complex of three interconnecting cavities or spaces (COCHLEA; VESTIBULAR LABYRINTH; and SEMICIRCULAR CANALS) in the TEMPORAL BONE. Within the bony labyrinth lies the membranous labyrinth which is a complex of sacs and tubules (COCHLEAR DUCT; SACCULE AND UTRICLE; and SEMICIRCULAR DUCTS) forming a continuous space enclosed by EPITHELIUM and connective tissue. These spaces are filled with LABYRINTHINE FLUIDS of various compositions. Labyrinth,Bony Labyrinth,Ear, Internal,Inner Ear,Membranous Labyrinth,Bony Labyrinths,Ears, Inner,Ears, Internal,Inner Ears,Internal Ear,Internal Ears,Labyrinth, Bony,Labyrinth, Membranous,Labyrinths,Labyrinths, Bony,Labyrinths, Membranous,Membranous Labyrinths
D008297 Male Males
D002102 Cadaver A dead body, usually a human body. Corpse,Cadavers,Corpses
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D004869 Equipment Safety Freedom of equipment from actual or potential hazards. Device Safety,Hazards, Equipment,Medical Device Safety,Safety, Equipment,Device Safety, Medical,Safety, Medical Device,Equipment Hazard,Equipment Hazards,Hazard, Equipment,Safety, Device
D005260 Female Females
D005336 Fiber Optic Technology The technology of transmitting light over long distances through strands of glass or other transparent material. Fiber Optic Technologies,Optic Technologies, Fiber,Optic Technology, Fiber,Technologies, Fiber Optic,Technology, Fiber Optic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013506 Otologic Surgical Procedures Surgery performed on the external, middle, or internal ear. Otologic Surgical Procedure,Procedure, Otologic Surgical,Procedures, Otologic Surgical,Surgical Procedure, Otologic,Surgical Procedures, Otologic
D013701 Temporal Bone Either of a pair of compound bones forming the lateral (left and right) surfaces and base of the skull which contains the organs of hearing. It is a large bone formed by the fusion of parts: the squamous (the flattened anterior-superior part), the tympanic (the curved anterior-inferior part), the mastoid (the irregular posterior portion), and the petrous (the part at the base of the skull). Stylomastoid Foramen,Bone, Temporal,Temporal Bones

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