Risks of Intracochlear Pressures From Laser Stapedotomy
| Autor: | Emily Misch, Nathaniel T. Greene, Renee M. Banakis Hartl, Samuel P. Gubbels |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_treatment
Ear Middle Mastoidectomy Stapes Surgery law.invention 03 medical and health sciences 0302 clinical medicine law otorhinolaryngologic diseases Humans Medicine 030223 otorhinolaryngology Sound pressure Cochlea business.industry Lasers Scala Tympani medicine.disease Laser Sensory Systems Footplate Sensory epithelium Otorhinolaryngology Sensorineural hearing loss Laser Therapy sense organs Neurology (clinical) business Cadaveric spasm 030217 neurology & neurosurgery Biomedical engineering |
| Zdroj: | Otology & Neurotology. 41:308-317 |
| ISSN: | 1537-4505 1531-7129 |
| Popis: | Hypothesis Surgical manipulations during laser stapedotomy can produce intracochlear pressure changes comparable to pressures created by high-intensity acoustic stimuli. Background New-onset sensorineural hearing loss is a known risk of stapes surgery and may result from pressure changes from laser use or other surgical manipulations. Here, we test the hypothesis that high sound pressure levels are generated in the cochlea during laser stapedotomy. Methods Human cadaveric heads underwent mastoidectomy. Fiber-optic sensors were placed in scala tympani and vestibuli to measure intracochlear pressures during key steps in stapedotomy surgery, including cutting stapedius tendon, lasering of stapedial crurae, crural downfracture, and lasering of the footplate. Results Key steps in laser stapedotomy produced high-intensity pressures in the cochlea. Pressure transients were comparable to intracochlear pressures measured in response to high intensity impulsive acoustic stimuli. Conclusion Our results demonstrate that surgical manipulations during laser stapedotomy can create significant pressure changes within the cochlea, suggesting laser application should be minimized and alternatives to mechanical downfracture should be investigated. Results from this investigation suggest that intracochlear pressure transients from stapedotomy may be of sufficient magnitude to cause damage to the sensory epithelium and affirm the importance of limiting surgical traumatic exposures. |
| Databáze: | OpenAIRE |
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