PubMed · 15742760
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Adam D Rubin, Robert T Sataloff. 2005. Visualization of a transtympanic ossicular prosthesis.. https://pubmed.ncbi.nlm.nih.gov/15742760/
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OBJECTIVE: The purpose of this study was to assess the value of virtual endoscopy (VE) in the diagnosis of lesions of the ossicular chain and to compare virtual endoscopy and two-dimensional (2D) spiral computed tomography (CT) data. STUDY DESIGN: Retrospective study. SETTING: A university hospital. PATIENTS: Fifty-eight patients with suspected ossicular chain lesions underwent a high-resolution CT of the temporal bone with both 2D data and VE before surgery. MAIN OUTCOME MEASURES: Two views were chosen for VE. The CT data obtained (2D, VE, and both 2D and VE) were compared with the lesions noted during surgery. RESULTS: In the diagnosis of dislocation of the ossicles or prostheses, VE seemed to be a better technique than 2D CT. Views chosen for the VE proved to be ineffective for diagnosing epitympanic fixations. VE was not adapted to the study of otosclerosis. We found it necessary to use the data provided by the addition to 2D CT data in the diagnosis of ossicular lysis and minor aplasia. Radiologic analysis of the lesions of the long process of the incus and the incudostapedial joint was improved by performing both 2D CT and VE. VE reconstruction of the stapes proved to be difficult, especially in cases of inflammation of the middle ear. CONCLUSION: This study demonstrates the value of VE in the diagnosis of dislocation of the ossicles and ossicular prostheses. VE was less effective in diagnosing other pathologies of the ossicular chain.
BACKGROUND: During the last few years, several laser systems have been applied for procedures in middle ear surgery. In this study, we determined the technical parameters for the dissection of the middle ear ossicles with the CO(2) laser and analyzed the histological findings. METHODS: The malleus necks of 16 human temporal bones were dissected under standardized conditions using a CO(2) laser with a power output between 35 and 55 kW/cm(2). The specimens were fixed and histological probes of 50- micro m thickness were prepared. RESULTS: The laser outputs led to crater diameters from 0.14 to 0.55 mm. As an analogy between laser energy and thermal tissue destruction, three zones of thermal damage were differentiated: a cinder zone, a carbonization zone, and a zone of dehydration. The metrical dimensions of these zones did not show any correlation to the applied laser energy. CONCLUSIONS: The data of this study show that commercially available CO(2) lasers are sufficient for a safe and effective partial resection of middle ear ossicles using a power output of 35 kW/cm(2).