Flexible fiberoptic endoscopy and laser surgery in obliterated cochleas: Human temporal bone studies

✍ Scribed by Kautzky, Michael; Susani, Martin; Franz, Peter; Zrunek, Michael

• Book ID: 102646095
• Publisher: John Wiley and Sons
• Year: 1996
• Tongue: English
• Weight: 744 KB
• Volume: 18
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/(sici)1096-9101(1996)18:3<271::aid-lsm9>3.0.co;2-p

✦ Synopsis

Background and Objectbe: The use of conventional drilling procedures in cochlear implant surgery of ossified cochleae poses special risks to the facial nerve and the carotid artery. This study evaluated the alternate use of flexible fiberoptic endoscopy and mid-infrared laser surgery for recanalization of partially and artificially obliterated cochleae in freshly dissected human cadavers. Study DesignlMaterials and Methods: A pulsed Ho1mium:YAGlaser ( h = 2120 nm) was used in the free-running mode (1180 mJ, 250 p s pulse, 5 Hz). A 660 Fm optic quartz fiber was positioned in the center of the round window niche and slowly-endoscopically guided-advanced in contact shooting over 1.5 cm, creating by vaporization and photoablation a passage through the artificial bony occlusion in the basal segment of the cochlea. Results: In all experiments, laser application (110-130 pulses) resulted in complete recanalization of the bony occlusions without damaging surrounding structures. The microendoscopy proved capable of guiding the laser fiber through the curved segment of the basal turn allowing identification of normal bone, bone cement, and laser-treated bone cement.

Conclusion:

If partial ossification of the basal turn is present, this technique could give access to place analog as well as digital implants deep within the cochlea.