Holmium-YAG Laser ablation characteristics in calvarial lamellar and cortical bone: The role of water and tissue micro-architecture

Towards phase-sensitive optical coherence tomography in smart laser osteotomy: temperature feedback

Thermal effects during bone surgery pose a common challenge, whether using mechanical tools or lasers. An irrigation system is a standard solution to cool the tissue and reduce collateral thermal damage. In bone surgery using Er:YAG laser, insufficient irrigation raises the risk of thermal damage, while excessive water lowers ablation efficiency. This study investigated the potential of optical coherence tomography to provide feedback by relating the temperature rise with the photo-thermal expansion of the tissue. A phase-sensitive optical coherence tomography system (central wavelength of λ=1.288 μm, a bandwidth of 60.9 nm and a sweep rate of 104.17 kHz) was integrated with an Er:YAG laser using a custom-made dichromatic mirror. Phase calibration was performed by monitoring the temperature changes (thermal camera) and corresponding cumulative phase changes using the phase-sensitive optical coherence tomography system during laser ablation. In this experiment, we used an Er:YAG laser with 230 mJ per pulse at 10 Hz for ablation. Calibration coefficients were determined by fitting the temperature values to phase later and used to predict the temperature rise for subsequent laser ablations. Following the phase calibration step, we used the acquired values to predict the temperature rise of three different laser-induced cuts with the same parameters of the ablative laser. The average root-mean-square error for the three experiments was measured to be around 4 °C. In addition to single-point prediction, we evaluated this method's performance to predict the tissue's two-dimensional temperature rise during laser osteotomy. The findings suggest that the proposed principle could be used in the future to provide temperature feedback for minimally invasive laser osteotomy.

Characterization of Ablated Bone and Muscle for Long-Pulsed Laser Ablation in Dry and Wet Conditions

Smart laser technologies are desired that can accurately cut and characterize tissues, such as bone and muscle, with minimal thermal damage and fast healing. Using a long-pulsed laser with a 0.5–10 ms pulse width at a wavelength of 1.07 µm, we investigated the optimum laser parameters for producing craters with minimal thermal damage under both wet and dry conditions. In different tissues (bone and muscle), we analyzed craters of various morphologies, depths, and volumes. We used a two-way Analysis of Variance (ANOVA) test to investigate whether there are significant differences in the ablation efficiency in wet versus dry conditions at each level of the pulse energy. We found that bone and muscle tissue ablated under wet conditions produced fewer cracks and less thermal damage around the craters than under dry conditions. In contrast to muscle, the ablation efficiency of bone under wet conditions was not higher than under dry conditions. Tissue differentiation was carried out based on measured acoustic waves. A Principal Component Analysis of the measured acoustic waves and Mahalanobis distances were used to differentiate bone and muscle under wet conditions. Bone and muscle ablated in wet conditions demonstrated a classification error of less than 6.66% and 3.33%, when measured by a microphone and a fiber Bragg grating, respectively.

Time and frequency resolved XeCl laser-induced mechanical transients in otic capsule bone

OBJECTIVE

This study identifies the presence of photoacoustic waves during excimer laser treatment of porcine otic capsule bone.

BACKGROUND DATA

Pulsed ultraviolet lasers have been suggested for use in middle ear surgery due to their potential for fiberoptic delivery, decreased thermal trauma, and precise ablation characteristics. However, the short pulse width of excimer lasers (typically 10-150 ns) can create large thermoelastic stresses in the ablation specimen.

MATERIALS AND METHODS

A XeCl (lambda = 308 nm, tau = 12 ns) excimer laser was used to ablate wafers of bone with energies of 90, 35, 13, 5, and 1.8 mJ/pulse. Custom high-frequency polyvinyldifluoride (PVDF) piezoelectric film transducers were fabricated and attached to the slices of bone. During ablation photoacoustic signals were amplified using a low-noise preamplifier and recorded on a digitizing oscilloscope.

RESULTS

Photoacoustic waves were clearly identified. Stress wave amplitude increased with laser fluence.

CONCLUSION

A laser fluence must be found that compromises between an increased ablation rate and increased stress wave amplitude. The acoustic power levels generated during ablation are below maximum exposure limits.

Comparison of cortical bone ablations by using infrared laser wavelengths 2.9 to 9.2 microm

BACKGROUND AND OBJECTIVE

The purpose of this study was to compare the ablation of cortical bone at wavelengths across the near and midinfrared region.

STUDY DESIGN/MATERIALS AND METHODS

An free electron laser generating 4-micros macropulses at specific wavelengths between 2.9 and 9.2 microm was used to ablate cortical bone. The same pulse intensity, repetition rate, radiant exposure, number of pulses, and delivery was used for each wavelength. Tissue removal, collateral thermal injury, and morphologic characteristics of the ablation sites were measured by light and scanning electron microscopy, and compared with the infrared absorption characteristics of cortical bone.

RESULTS

Within the parameters used, bone ablation was found to be wavelength dependent. Incisions were deepest where protein has strong absorption, and were most shallow where mineral is a strong absorber. No char was observed on ablation surfaces where 3.0, and 5.9-6.45 microm wavelengths were used.

CONCLUSIONS

The use of wavelengths in the 6.1-microm amide I to 6.45-microm amide II region, with the pulse characteristics described, were the most efficient for cutting cortical bone and produced less collateral thermal injury than cutting with a surgical bone saw. This study confirms previous observations that the ablation mechanism below plasma threshold is consistent with an explosive process driven by internal vaporization of water in a confined space and demonstrates that ablation is enhanced by using wavelengths that target the protein matrix of cortical bone.