Laser assisted fixation of ear prostheses after stapedectomy

Three different lasers (erbium:YAG, holmium:YAG, alexandrite) were used to drill a hole at the end of the long process of the incus in order to fix an ear prosthesis after stapedectomy or small fenestra stapedectomy. The energy was coupled into a 250-microns core diameter zirconium-fluoride fiber. The operations were carried out on human temporal bone models from cadavers. The fiber was guided to the incus under the stereoscopic surgical microscope. The tissue response was examined under the scanning electron microscope, and after decalcification, histologically. These studies suggest the feasibility of using the erbium:YAG laser to improve the anchorage of the prosthesis on the incus and to increase the stability in ossicular chain reconstruction.