Article
One shot stapedotomy with the CO2 laser
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Authors
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Sergije Jovanovic
- Charité - University Medical Center, Campus Benjamin Franklin, ENT Dept., Berlin
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Uwe Schönfeld
- Charité - University Medical Center, Campus Benjamin Franklin, ENT Dept., Berlin
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Hans Scherer
- Charité - University Medical Center, Campus Benjamin Franklin, ENT Dept., Berlin
| Published: | September 22, 2005 |
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Outline
Text
The idea of applying the CO2 laser as a precise and contact-free instrument in middle-ear surgery and especially in stapes surgery is based on the desire to reduce the complication rate of these interventions by further optimizing the surgical techniques. Today, using high-precision micromanipulators, the laser beam can be focused to a spot diameter of 180 mm. New application modes combined with scanner systems enable an exact adjustment to the demands of stapes surgery, thus permitting the finest microsurgical work. “One-shot“ stapedotomy can be achieved by microprocessor-controlled movement of the focused laser beam over a defined area (diameter: 0.5 to 0.7 mm) by rotating mirrors (scanner).
On the basis of experimental data, effective parameters were determined with the CO2 laser and applied in the clinical routine.
The film shows the advantages of the new CO2 laser stapedotomy technique with “one-shot“. The surgical technique is presented and the varying demands made on the laser beam when working on the stapedius tendon, crura and footplate are discussed.
The risk of chain luxation, particularly footplate mobilization (floating footplate) or damage to the adjacent middle and inner ear structures is practically impossible with the limitation of the energy parameters used here.
