Laser-assisted fixation of a nitinol stapes prosthesis.

Laser-assisted fixation of a nitinol stapes prosthesis.

Lasers Surg Med. 2017 Nov 02;:

Authors: Schrötzlmair F, Suchan F, Pongratz T, Krause E, Müller J, Sroka R

Abstract
BACKGROUND AND OBJECTIVE: 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.
STUDY DESIGN AND MATERIALS AND METHODS: Closure of the NiTiBOND® prosthesis was induced ex vivo by either a diode laser emitting at λ = 940 nm or a CO2 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.
RESULTS: 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.
CONCLUSION: 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. © 2017 Wiley Periodicals, Inc.

PMID: 29095508 [PubMed - as supplied by publisher]

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