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Published on: August 13, 2019
In vivo laser tissue welding in the rabbit maxillary sinus.
Benjamin S Bleier1, James N Palmer, Michael A Gratton
1Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104-4206, USA. benjamin.bleier@uphs.upenn.edu
Laser tissue welding (LTW) creates strong, durable bonds in sinonasal tissue, exceeding human intracranial pressure without causing thermal damage. This endoscopic technique shows promise for skull base repair and reducing cerebrospinal fluid (CSF) leaks.
Area of Science:
- Biomedical Engineering
- Surgical Innovation
- Tissue Repair
Background:
- Skull base reconstruction in endoscopic sinonasal surgery presents challenges.
- Postoperative cerebrospinal fluid (CSF) leaks are a complication.
- Laser tissue welding (LTW) offers a potential solution for durable tissue bonding.
Purpose of the Study:
- To evaluate the efficacy of LTW in creating robust tissue bonds in sinonasal mucosa.
- To assess wound healing and thermal injury associated with LTW.
- To determine if LTW can prevent CSF leaks in skull base reconstruction.
Main Methods:
- LTW was applied to sinonasal mucosal incisions in New Zealand white rabbits.
- Burst pressure thresholds were measured at 0, 5, and 15 days post-operation.
- Histological examination assessed thermal injury, inflammation, and fibroplasia.
Main Results:
- LTW bonds demonstrated significantly higher burst pressures than controls on postoperative days 0 and 5.
- No significant difference in burst pressure was observed by day 15.
- Histology revealed negligible thermal injury, inflammation, or fibroplasia.
Conclusions:
- LTW effectively creates durable tissue bonds in sinonasal tissue exceeding human intracranial pressure.
- The technique results in minimal collateral thermal injury.
- Endoscopic LTW is a viable option for CSF leak prevention and skull base repair.
