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  Picosecond Infrared Laser (PIRL) Application in Stapes Surgery—First Experience in Human Temporal Bones

Petersen, H., Gliese, A., Stober, Y., Maier, S., Hansen, N.-O., Kruber, S., et al. (2018). Picosecond Infrared Laser (PIRL) Application in Stapes Surgery—First Experience in Human Temporal Bones. Otology & Neurotology, 39(4), e224-e230. doi:10.1097/MAO.0000000000001753.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0001-DD25-D Version Permalink: http://hdl.handle.net/21.11116/0000-0002-5019-8
Genre: Journal Article

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Picosecond_Infrared_Laser__PIRL__Application_in.5.pdf (Publisher version), 500KB
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Picosecond_Infrared_Laser__PIRL__Application_in.5.pdf
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This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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2018
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 Creators:
Petersen, H.1, Author
Gliese, A.1, Author
Stober, Y.1, Author
Maier, S.2, Author              
Hansen, N.-O.2, Author              
Kruber, S.2, Author              
Eggert, D.3, Author
Tóth, M.1, Author
Gosau, T.4, Author
Schlüter, H.5, Author
Püschel, K.6, Author
Schumacher, U.4, Author
Miller, R. J. D.2, Author              
Münscher, A.1, Author
Dalchow, C.7, Author
Affiliations:
1Department of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Center Hamburg-Eppendorf, ou_persistent22              
2Miller Group, Atomically Resolved Dynamics Department, Max Planck Institute for the Structure and Dynamics of Matter, Max Planck Society, ou_1938288              
3Heinrich-Pette-Institute, Leibnitz Institute of Experimental Virology, ou_persistent22              
4Department of Anatomy and Experimental Morphology, ou_persistent22              
5Department of Clinical Chemistry, University Medical Center Hamburg-Eppendorf, ou_persistent22              
6Department of Legal Medicine, ou_persistent22              
7Department of Otorhinolaryngology, Klinikum Frankfurt Höchst, ou_persistent22              

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Free keywords: Laser surgery; Otosclerosis; Stapedotomy; Stapes surgery
 Abstract: Objective: Using a contact-free laser technique for stapedotomy reduces the risk of mechanical damage of the stapes footplate. However, the risk of inner ear dysfunction due to thermal, acoustic, or direct damage has still not been solved. The objective of this study was to describe the first experiences in footplate perforation in cadaver tissue performed by the novel Picosecond-Infrared-Laser (PIRL), allowing a tissue preserving ablation. Patients and Intervention: Three human cadaver stapes were perforated using a fiber-coupled PIRL. The results were compared with footplate perforations performed with clinically applied Er:YAG laser. Therefore, two different laser energies for the Er:YAG laser (30 and 60 mJ) were used for footplate perforation of three human cadaver stapes each. Main Outcome Measure: Comparisons were made using histology and environmental scanning electron microscopy (ESEM) analysis. Results: The perforations performed by the PIRL (total energy: 640–1070 mJ) revealed a precise cutting edge with an intact trabecular bone structure and no considerable signs of coagulation. Using the Er:YAG-Laser with a pulse energy of 30 mJ (total energy: 450–600 mJ), a perforation only in the center of the ablation zone was possible, whereas with a pulse energy of 60 mJ (total energy: of 195–260 mJ) the whole ablation zone was perforated. For both energies, the cutting edge appeared irregular with trabecular structure of the bone only be conjecturable and signs of superficial carbonization. Conclusion: The microscopic results following stapes footplate perforation suggest a superiority of the PIRL in comparison to the Er:YAG laser regarding the precision and tissue preserving ablation.

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Language(s): eng - English
 Dates: 2018-042018-04
 Publication Status: Published in print
 Pages: 7
 Publishing info: -
 Table of Contents: -
 Rev. Method: Peer
 Identifiers: DOI: 10.1097/MAO.0000000000001753
 Degree: -

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Title: Otology & Neurotology
Source Genre: Journal
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Publ. Info: Philadelphia : Lippincott, Williams & Wilkins
Pages: - Volume / Issue: 39 (4) Sequence Number: - Start / End Page: e224 - e230 Identifier: ISSN: 1531-7129
CoNE: /journals/resource/1531-7129