Erbium laser in middle ear surgery: laboratory study

Cadaveric human temporal bones, cadaveric rabbits, and live rats were used to demonstrate the use and safety of the erbium:yttrium-scandium-gallium-garnet (Er:YSGG) laser for otologic applications: for dissection and precise drilling of bone. The shallow penetration of this wavelength and hence minimal collateral thermal effects spare underlying middle and inner ear structures and make it appealing for stapedotomy. Temperature measurements from the round window area during Er:YSGG stapedotomy recorded an elevation of less than 2 degree(s)C, which is well within acceptable limits. Ablation of bone was good and efficient. An acoustic shock produced at the impact site is the major disadvantage and requires further in vivo investigation of the transient and sustained deleterious effects away from the application site. This work supports further investigation into potential applications of the Er:YSGG laser in otology.