山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (4): 75-79.doi: 10.6040/j.issn.1673-3770.0.2015.552

• 论著 • 上一篇    下一篇

脉冲CO2激光与Er:YAG激光中耳骨消融的实验研究

王晓燕1,郑燕青2,郑昊1,叶青1   

  1. 1.福建医科大学省立临床医学院耳鼻咽喉科, 福建 福州 350001;
    2.泉州市妇幼保健院·儿童医院, 福建 泉州 362000
  • 收稿日期:2015-12-29 出版日期:2016-08-16 发布日期:2016-08-16
  • 通讯作者: 叶青. E-mail:1158113213@qq.com E-mail:wxiaoyan0407@163.co
  • 作者简介:王晓燕. E-mail:wxiaoyan0407@163.co
  • 基金资助:
    国家自然科学基金资助项目(61475036);福建省自然科学基金项目(2011J01135);福建省临床重点专科建设项目［闽卫医政(2015)593号］

Bone ablation in middle ear with pulsed CO2 laser and Er:YAG laser: an experimental study.

WANG Xiaoyan1, ZHENG Yanqing2, ZHENG Hao1, YE Qing   

  1. 1. Department of Otolaryngology, Provincial Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China;2. Quanzhou Women and Childrens Hospital, Quanzhou 362000, Fujian, China
  • Received:2015-12-29 Online:2016-08-16 Published:2016-08-16

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摘要： 目的 建立激光中耳骨消融的活体动物模型,初步研究脉冲CO2激光及Er:YAG激光中耳骨消融的可行性,在耳科手术中寻求除电钻外另一快速、安全的手术工具方式。 方法 24只兔分为三组,分别采用电钻、CO2激光、Er:YAG激光为手术工具,研磨或消融中耳骨至暴露中耳腔,比较三种工具活体动物中实际操作的可行性,观察实验现象,比较手术速度,并利用连续组织切片HE染色技术检测周围组织形态改变。 结果 在活体兔实验模型中,两种激光系统及传统电钻都可达到有效开窗,三组手术工具开窗所用时间长短不一;三组暴露中耳腔所用时间差异无统计学意义(P>0.05);电钻磨骨与激光消融骨组织形态改变相似。 结论 使用激光可迅速消融骨质暴露中耳腔,激光可作为除电钻外的另一耳科手术工具。

关键词: 电钻, 中耳, CO2激光, Er:YAG激光, 骨消融

Abstract: Objective To study the feasibility of bone ablation in middle ear with pulsed CO2 laser and Er:YAG laser in rabbit models, in order to provide a new and safe tool for fenestration operation in middle ear. Methods A total of 24 New Zealand rabbits were randomly divided into 3 groups: drill group, CO2 laser group, and Er:YAG laser group. The three tools were used to perform fenestration operation of middle ear. The feasibility of bone ablation, experimental phenomena, total operation time and light irradiation time, and opening efficiency were compared. The morphologic changes of adjacent tissues were observed with tissue slicing and HE staining after irradiation. Results All of the three approaches were suitable for fenestration operation of middle ear bone, with different operation time, but there was no statistical difference(P>0.05). The three groups had similar morphologic characteristics after fenestration. Conclusion Both pulsed CO2 laser and Er:YAG laser can ablate bone rapidly in the fenestration operation, which can serve as a new tool in otological surgeries besides electric drill.

Key words: Middle ear, Er:YAG laser, Bone ablation, Electric drill, CO2 laser

中图分类号: 

  • R764.9
[1] Michaelides E M, Kartush J M. Implications of sound levels generated by otologic devices[J]. Otolaryngol Head Neck Surg, 2001, 125(4): 361-363.
[2] Szyfter W, Mielcarek-Kuchta D, Modkowska A, et al. Stapedotomie with the use of CO2 laser-“one shot” technique[J]. Otolaryngol Pol, 2013, 67(2): 87-94.
[3] Albers A E, Schönfeld U, Kandilakis K, et al. CO2 laser revision stapedotomy[J]. Laryngoscope, 2013, 123(6): 1519-1526.
[4] 李永新, 张国平, 王顺成, 等. 耳道内径路CO2激光镫骨手术治疗耳硬化症[J]. 中国医学文摘: 耳鼻咽喉科学, 2011, 26(6):324-325. LI Yongxin, ZHANG Guoping, WANG Shuncheng, et al. CO2 laser stape surgery through the ear canal on the treatment of otosclerosis[J]. Chin Med Digest: Otolaryngol, 2011, 26(6):324-325.
[5] Elmadag M, Uzer G, Yildiz F, et al. Comparison of four different techniques for performing an osteotomy: a biomechanical, radiological and histological study on rabbits tibias[J]. Bone Joint J, 2015, 97-B(12):1628-1633.
[6] Panduric D G, Juric I B, Music S, et al. Morphological and ultrastructural comparative analysis of bone tissue after Er:YAG laser and surgical drill osteotomy[J]. Photomed Laser Surg, 2014, 32(7):401-408.
[7] Stefan Stübinger. Advances in bone surgery: the Er:YAG laser in oral surgery and implant dentistry[J]. Clin Cosmet Investig Dent, 2010, 2:47-62.
[8] 王晓燕, 叶青, 沈帆, 等. 兔中耳进路及中耳解剖结构的研究[J]. 山东大学耳鼻喉眼学报, 2011, 25(6):37-40. WANG Xiaoyan, YE Qing, SHEN Fan, et al. Rabbits middle ear approach and its anatomic structure[J]. J Otolaryngol Ophthalmol Shandong Univ, 2011, 25(6):37-40.
[9] Zhang X, Zhan Z, Liu H, et al. Influence of water layer thickness on hard tissue ablation with pulsed CO2 laser[J]. J Biomed Opt, 2012, 17(3):038003.
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