Mehari Fanuel, Rohde Maximilian, Knipfer Christian, Kanawade Rajesh, Klämpfl Florian, Adler Werner, Stelzle Florian, Schmidt Michael
Clinical Photonics Lab, Erlangen Graduate School in Advanced Optical Technologies (SAOT), Friedrich-Alexander-Universität Erlangen-Nürnberg, Paul-Gordan-Strasse 6, 91052 Erlangen, Germany ; Institute of Photonic Technologies, Friedrich-Alexander-Universität Erlangen-Nürnberg, Konrad-Zuse-Straße 3/5, 91052 Erlangen, Germany.
Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Glückstrasse 11, 91054 Erlangen, Germany.
Biomed Opt Express. 2014 Oct 21;5(11):4013-23. doi: 10.1364/BOE.5.004013. eCollection 2014 Nov 1.
Laser surgery enables for very accurate, fast and clean modeling of tissue. The specific and controlled cutting and ablation of tissue, however, remains a central challenge in the field of clinical laser applications. The lack of information on what kind of tissue is being ablated at the bottom of the cut may lead to iatrogenic damage of structures that were meant to be preserved. One such example is the shaping or removal of diseased cartilaginous and bone tissue in the temporomandibular joint (TMJ). Diseases of the TMJ can induce deformation and perforation of the cartilaginous discus articularis, as well as alterations to the cartilaginous surface of the condyle or even the bone itself. This may result in restrictions of movement and pain. The aim of a surgical intervention ranges from specific ablation and shaping of diseased cartilage, bone or synovial tissues to extensive removal of TMJ structures. One approach to differentiate between these tissues is to use Laser Induced Breakdown Spectroscopy (LIBS). The ultimate goal is a LIBS guided feedback control system for surgical laser systems that enables real-time tissue identification for tissue specific ablation. In the presented study, the authors focused on the LIBS based differentiation between cartilage tissue and cortical bone tissue using an ex-vivo pig model.
激光手术能够对组织进行非常精确、快速且干净的建模。然而，对组织进行特定且可控的切割和消融，仍然是临床激光应用领域的一个核心挑战。在切口底部，缺乏关于正在被消融的是何种组织的信息，可能会导致本应保留的结构受到医源性损伤。一个这样的例子是颞下颌关节（TMJ）中病变软骨和骨组织的塑形或切除。TMJ疾病可导致关节盘软骨变形和穿孔，以及髁突软骨表面甚至骨本身的改变。这可能会导致运动受限和疼痛。手术干预的目的从对病变软骨、骨或滑膜组织进行特定消融和塑形，到广泛切除TMJ结构不等。区分这些组织的一种方法是使用激光诱导击穿光谱法（LIBS）。最终目标是为手术激光系统建立一个基于LIBS的反馈控制系统，该系统能够实现用于组织特异性消融的实时组织识别。在本研究中，作者使用离体猪模型，重点研究了基于LIBS的软骨组织和皮质骨组织之间的区分。
