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Carbon Dioxide Laser StapedotomyThermal Effects in the Vestibule
Newton J. Coker, MD;
Gregory A. Ator, MD;
Herman A. Jenkins, MD;
Charles R. Neblett, MD;
James R. Morris
Arch Otolaryngol. 1985;111(9):601-605.
Abstract
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• Small-fenestra stapedotomy has recently been popularized in efforts to reduce the incidence of sensorineural hearing loss following stapes surgery for otospongiosis. Lasers have been advocated as a tool to fenestrate the stapes footplate. Conversion of radiant energy from the laser into heat in the vestibule represents the greatest potential risk to the inner ear. Using a carbon dioxide laser with a focal point of 150 µm at 300 mm, fenestrations of the stapes footplate were performed in a series of 14 anesthetized cats. The laser power output ranged from 0.47 to 3.05 W, with pulse durations of 0.2 and 0.5 s. Resultant temperature elevations in the vestibule, measured by a thin-wire thermocouple, ranged from 0 to 4.4 °C (0 to 8 °F) and directly correlated to wattage and duration of the laser-beam pulse. Temperature changes could be reduced by use of lower wattage, shorter pulse duration, timed intervals between pulses, and convection cooling of the promontory.
(Arch Otolaryngol 1985;111:601-605)
Author Affiliations
From the Department of Otorhinolaryngology and Communicative Sciences (Drs Coker, Ator, and Jenkins) and the Department of Neurosurgery (Dr Neblett), Baylor College of Medicine, and BioQuantum Technologies (Mr Morris), Houston.
Footnotes
Accepted for publication March 5, 1985.
Read before the Association for Research in Otolaryngology Forum, annual meeting of the American Academy of Otolaryngology—Head and Neck Surgery, Las Vegas, Sept 15, 1984.
Reprint requests to Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030 (Dr Coker).
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