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手术显微镜的照明特性。

The illumination characteristics of operative microscopes.

作者信息

Schutt Christopher A, Redding Brandon, Cao Hui, Michaelides Elias

机构信息

Yale Department of Surgery Section of Otolaryngology, New Haven, CT.

Yale Department of Applied Physics, New Haven, CT.

出版信息

Am J Otolaryngol. 2015 May-Jun;36(3):356-60. doi: 10.1016/j.amjoto.2014.12.009. Epub 2015 Jan 9.

Abstract

PURPOSE

Modern operative microscopes use light sources which possess the power to severely damage underlying tissue. Currently, manufacturers provide a safety warning of this possibility. However, they are unable to suggest specific settings due to a stated "lack of scientific publications on this topic". We aim to radiometrically evaluate multiple otologic microscopes at variables which effect irradiance in order to determine reference emissions levels and provide guidelines for improved intraoperative safety.

MATERIALS AND METHODS

The optical radiance of four otologic microscopes was evaluated at variable field illumination sizes (spot size), intensity settings and working distances. The spectral emission of each microscope was separately measured. The energy absorbed in skin with representative properties was then calculated as a function of time for each microscope by accounting for the emission spectrum of the microscope and the absorption spectrum of skin.

RESULTS

Microscopes showed a wide range of optical radiance based on model, spots size, intensity setting and working distances. Spectral emission of all four microscopes was centered in the visible spectrum with minimal ultraviolet or infrared contribution. A large amount of energy is absorbed by skin during usage of operative microscopes. The highest calculated absorption at 200 min of use was 736.26 J/cm(2).

CONCLUSIONS

Operative microscopes have the ability to cause patient morbidity secondary to the energy they impart. In an effort to decrease potential injury we recommend that physicians be aware of their microscopes properties and how to control variables which effect irradiance of the skin.

摘要

目的

现代手术显微镜所使用的光源具有严重损伤深层组织的能力。目前,制造商已针对这种可能性给出安全警告。然而,由于声称“缺乏关于该主题的科学出版物”,他们无法给出具体的设置建议。我们旨在通过辐射测量法评估多台耳科显微镜在影响辐照度的多个变量下的情况,以确定参考发射水平,并为提高术中安全性提供指导方针。

材料与方法

在不同的视野照明尺寸(光斑大小)、强度设置和工作距离下,对四台耳科显微镜的光学辐射度进行评估。分别测量每台显微镜的光谱发射。然后,通过考虑显微镜的发射光谱和皮肤的吸收光谱,计算出具有代表性特性的皮肤在每个显微镜下随时间吸收的能量。

结果

根据型号、光斑大小、强度设置和工作距离的不同,显微镜显示出广泛的光学辐射度范围。所有四台显微镜的光谱发射都集中在可见光谱范围内,紫外线或红外线的贡献极小。在使用手术显微镜期间,皮肤会吸收大量能量。使用200分钟时计算出的最高吸收量为736.26 J/cm²。

结论

手术显微镜因其传递的能量有导致患者发病的可能。为了减少潜在伤害,我们建议医生了解他们所使用显微镜的特性以及如何控制影响皮肤辐照度的变量。

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