Schrötzlmair Florian, Suchan Fabian, Pongratz Thomas, Krause Eike, Müller Joachim, Sroka Ronald
Klinik und Poliklinik für Hals-, Nasen-und Ohrenheilkunde, Ludwig-Maximilians-Universität München, Marchioninistraße 15, München 81377, Germany.
LIFE-Zentrum, Klinik und Poliklinik für Urologie, Ludwig-Maximilians-Universität München, Marchioninistraße 15, München 81377, Germany.
Lasers Surg Med. 2018 Feb;50(2):153-157. doi: 10.1002/lsm.22738. Epub 2017 Nov 2.
Otosclerosis is an inner ear bone disease characterized by fixation of the stapes and consequently progressive hearing loss. One treatment option is the surgical replacement of the stapes by a prosthesis. When so called "smart materials" like nitinol are used, prosthesis fixation can be performed using a laser without manual crimping on the incus. However, specific laser-prosthesis interactions have not been described yet. The aim of the present study was to elucidate the thermo-mechanical properties of the NiTiBOND® prosthesis as a basis for handling instructions for laser-assisted prosthesis fixation.
Closure of the NiTiBOND® prosthesis was induced ex vivo by either a diode laser emitting at λ = 940 nm or a CO laser (λ = 10,600 nm). Total energy for closure was determined. Suitable laser parameters (pulse duration, power per pulse, distance between tip of the laser fiber and prosthesis) were assessed. Specific laser-prosthesis interactions were recorded.
Especially the diode laser was found to be an appropriate energy source. A total energy deposit of 60 mJ by pulses in near contact application was found to be sufficient for prosthesis closure ex vivo. Energy should be transmitted through a laser fiber equipollent to the prosthesis band diameter. Specific deformation characteristics due to the zonal prosthesis composition have to be taken into account.
NiTiBOND® stapes prosthesis can be closed by very little energy when appropriate energy sources like diode lasers are used, suggesting a relatively safe application in vivo. Lasers Surg. Med. 50:153-157, 2018. © 2017 Wiley Periodicals, Inc.
耳硬化症是一种内耳骨疾病，其特征是镫骨固定，进而导致进行性听力损失。一种治疗选择是用假体手术替换镫骨。当使用诸如镍钛合金等所谓的“智能材料”时，假体固定可通过激光进行，而无需在砧骨上进行手动压接。然而，特定的激光 - 假体相互作用尚未见报道。本研究的目的是阐明NiTiBOND®假体的热机械性能，作为激光辅助假体固定操作指南的基础。
研究设计、材料与方法：通过发射波长λ = 940 nm的二极管激光或CO激光（λ = 10,600 nm）在体外诱导NiTiBOND®假体闭合。确定闭合所需的总能量。评估合适的激光参数（脉冲持续时间、每脉冲功率、激光光纤尖端与假体之间的距离）。记录特定的激光 - 假体相互作用。
特别发现二极管激光是一种合适的能量源。发现在近接触应用中，脉冲总能量沉积60 mJ足以在体外实现假体闭合。能量应通过与假体带直径相当的激光光纤传输。必须考虑到由于假体区域组成导致的特定变形特性。
当使用诸如二极管激光等合适的能量源时，NiTiBOND®镫骨假体只需极少能量即可闭合，这表明在体内应用相对安全。《激光外科与医学》50:153 - 157, 2018。© 2017威利期刊公司
