Baum Olga I, Soshnikova Yulia M, Sobol Emil N, Korneychuk Andrey Ya, Obrezkova Mariya V, Svistushkin Valeriy M, Timofeeva Oxana K, Lunin Valeriy V
Institute on Laser & Information Technologies, Russian Academy of Sciences, Troitsk 142190, Russia.
Lasers Surg Med. 2011 Aug;43(6):511-5. doi: 10.1002/lsm.21077.
Laser reshaping of cartilage is a new effective and safe technique for correction of nasal septum and ear deformities. Costal cartilage is a most suitable natural material for transplantation. The problem is to obtain stable proper shape of cartilage implants. The objective of this article is to study reshaping of porcine costal cartilage for larynx stenosis surgery using Erbium glass fiber laser.
Porcine cartilage plates 3 mm in thickness were mechanically curved and irradiated (1) on one side (stretched or compressed) and (2) on both sides with different sequence. Irradiation was performed using a 1.56 µm laser with power varied from 1 to 2.5 W, exposure time from 5 to 20 seconds, spot diameter of 2.5 mm, pulse duration of 500 milliseconds, pulse repetition rate of 1.4 Hz. For each laser setting, stable curvature radius was measured during 24 hours after the experiment. Irradiated samples were analyzed by means of differential scanning calorimerty (DSC) to reveal the collagen denaturation degree.
The optimum laser setting for stable reshaping of costal cartilage without visual thermal damage of cartilage matrix was established: laser power of 2.2 W, exposure time of 6 seconds. Nonlinear thermomechanical behavior of cartilage in the course of its laser reshaping is experimentally revealed. The influence of irradiation sequence on the curvature radius of cartilage implant is found for the first time. It is shown that (1) it is possible to use laser reshaping technique for making stable proper shape of costal cartilage, and (2) primary irradiation of compressed side followed with an irradiation of stretched side is more effective than reverse sequence of laser treatment. DSC analysis showed that thermal effect of irradiated specimens (2.58-3.79 J/g) was slightly lower that that for intact cartilage specimens and considerably lower than that for denaturation of collagen (65 ± 5 J/g).
It is possible to use laser reshaping technique for preparation of stable cartilage implants. Nonlinear thermomechanical behavior of cartilage is experimentally revealed. The influence of irradiation sequence on curvature radius of cartilage grafts is established for the first time.
激光重塑软骨是一种用于鼻中隔和耳部畸形矫正的新型有效且安全的技术。肋软骨是最适合移植的天然材料。问题在于获得形状稳定且合适的软骨植入物。本文的目的是研究使用铒玻璃纤维激光对猪肋软骨进行重塑以用于喉狭窄手术。
将厚度为3毫米的猪软骨板进行机械弯曲，并以不同顺序对其（1）一侧（拉伸或压缩）和（2）两侧进行照射。使用波长为1.56微米的激光进行照射，功率范围为1至2.5瓦，曝光时间为5至20秒，光斑直径为2.5毫米，脉冲持续时间为500毫秒，脉冲重复频率为1.4赫兹。对于每种激光设置，在实验后的24小时内测量稳定的曲率半径。通过差示扫描量热法（DSC）对辐照后的样本进行分析，以揭示胶原蛋白的变性程度。
确定了在不造成软骨基质明显热损伤的情况下实现肋软骨稳定重塑的最佳激光设置：激光功率为2.2瓦，曝光时间为6秒。通过实验揭示了软骨在激光重塑过程中的非线性热机械行为。首次发现了照射顺序对软骨植入物曲率半径的影响。结果表明：（1）可以使用激光重塑技术使肋软骨形成稳定且合适的形状；（2）先对压缩侧进行初次照射，然后再对拉伸侧进行照射比相反的激光治疗顺序更有效。DSC分析表明，辐照样本的热效应（2.58 - 3.79焦耳/克）略低于完整软骨样本，且远低于胶原蛋白变性的热效应（65±5焦耳/克）。
可以使用激光重塑技术制备形状稳定的软骨植入物。通过实验揭示了软骨的非线性热机械行为。首次确定了照射顺序对软骨移植物曲率半径的影响。
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