Compatibility of the argon and KTP lasers with middle ear implants

Visible-spectrum lasers (argon, KTP) are becoming common tools in otology. Concern over transmission of disease by homograft tissue has focused attention on synthetic materials such as Silastic, Polycel, hydroxylapatite, and Teflon. This study sought to determine the effects of argon and KTP lasers on materials used in stapes and chronic ear surgery. Silastic sheeting, hydroxylapatite and polycel total ossicular replacement prostheses (TORPs) and partial ossicular replacement prostheses (PORPs), and platinum wire/Teflon stapes prostheses were exposed to argon and KTP laser energy at clinical power settings. Effects of the two lasers were similar. The presence of pigment (char or blood) was necessary to produce any effect. Silastic transmitted energy to underlying material. Hydroxylapatite cracked and shattered. Polycel vaporized and melted, as did Teflon. Clinical implications of these interactions on primary and revision otologic surgeries will be discussed.