Ultrashort pulse laser ossicular ablation and stapedotomy in cadaveric bone*†

BACKGROUND AND OBJECTIVE: The purpose of this study was to evaluate the ablation of ossicular tissue using a 1,053 nm Ti:Sapphire chirped pulse amplifier laser system configured to deliver ultrashort pulses of 350 femtoseconds (fs) (3.5x10(-13) seconds) in cadaver temporal bone. STUDY DESIGN/MATERIALS AND METHODS: Ablation of the formalin-fixed incus and stapes was performed using an ultrashort pulse laser (USPL) (0.4 mm beam diameter, pulse fluence of 2.0 J/cm2, and pulse repetition rate of 10 Hz). The ablation rate was measured using optical micrometry, and crater surface morphology examined using scanning electron microscopy. RESULTS: The laser produced precise bone ablation at a rate of 1.26 microm/pulse, with almost no evidence of thermal damage, and very little evidence of photomechanical injury. CONCLUSIONS: Ultrashort pulse lasers may provide a useful clinical tool for otologic and skull base surgery, where precise hard tissue ablation is required adjacent to critical structures.