Is the holmium laser the proper laser for ablation of bone and cartilage in ENT?

Hans-Jochen Foth; Thomas G. Barton; Marc Bressem; Dirk H. Meyer; Karl Hoermann M.D.

doi:10.1117/12.209101

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12 May 1995 Is the holmium laser the proper laser for ablation of bone and cartilage in ENT?

Hans-Jochen Foth, Thomas G. Barton, Marc Bressem, Dirk H. Meyer, Karl Hoermann M.D.

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Proceedings Volume 2395, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems V; (1995) https://doi.org/10.1117/12.209101
Event: Photonics West '95, 1995, San Jose, CA, United States

Abstract

The combination of the short penetration length in water and the delivery through flexible quartz fibers made the radiation of the Holmium laser very promising for minimal invasive surgery. Furthermore the available power density of 10⁶ W/cm² overcomes the threshold for ablation, which opens the way for cutting and removal of bone and cartilage, which is important for surgery especially in ENT. In contradiction, recently warning had been brought up that particularly in cartilage the damage zone can exceed the ablation zone by orders of magnitude and one should be restrictive using the Holmium laser for joint surgery. We found that the effect of Holmium laser radiation on tissue cannot be described by a pure absorption and ablation process. Experimental data showed that in the case of bone scattering has to be considered, and in the case of cartilage a remarkable heating of the remaining tissue occurred. This amount of heating could be reduced significantly by a new designed fiber mount, which cooled the tissue.

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Hans-Jochen Foth, Thomas G. Barton, Marc Bressem, Dirk H. Meyer, and Karl Hoermann M.D. "Is the holmium laser the proper laser for ablation of bone and cartilage in ENT?", Proc. SPIE 2395, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems V, (12 May 1995); https://doi.org/10.1117/12.209101

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