Preliminary investigation of CTH:YAG laser for cochlear implantation

摘要

Abstract: Cochlear implantation is a treatment for deafness that requires the surgical placement of electrodes within the cochlea, using a high-speed drill. While the drill is effective, the tip of the drill or the drill shaft may damage critical adjacent structures, such as the facial nerve. In addition, the narrow working spaces involved in this surgery make the drill a relatively cumbersome tool for such delicate work. The use of a flexible fiber to deliver the laser energy may make the surgery easier by allowing a more maneuverable instrument to access the region, while reducing the risk of injuring adjacent structures. We report our preliminary investigation of fiber delivery of CTH:YAG energy ($lambda equals 2091 nm) for the purpose of bony ablation. A 550 micron diameter low-OH silica fiber was used to drill through up to 2.5 mm thick human temporal bone specimens. An average of 14 pulses was required for 1 mm thick bones, and an average of 33 pulses required to ablate 2 mm of bone. The holes drilled were precise, and showed limited adjacent tissue effect by gross and histopathologic evaluation. This work demonstrates the effective fiberoptic delivery of CTH:YAG energy for bone ablation. Further work is warranted to explore the clinical possibilities offered by this technique for precise bony ablation with limited adjacent tissue effect. !7