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Dr. Michaelides: Today I performed a Tympanoplasty on an ear drum that
was severely atelectatic or collapsed into the middle ear.
Because of that there was a fair bit of
adhesions between the ear drum and structures
in the middle ear, such as the
cochlea, the promontory of the cochlea, and the stapes and incus.
I also elevated the drum off of the malleus so that I could put a graft
underneath the ear drum. The particular device I used today
which was the BeamPath S,
has a very thin narrowed tip which is very useful in otologic applications.
It allows us to
deliver a very small spot size to the area that we want without having a lot
of bulk to it
so that we can see around the device through our microscope.
The use of the CO2 fiber, in this case, was used to
remove some of the scar tissue and free up the adhesions
without causing any vibrational trauma
to those delicate middle ear structures.
In elevating a drum off of, say the stapes,
where there are adhesions
you may end up moving the stapes a fair bit if you're using manual dissection with instruments.
However, with the laser fiber we were able to change the approach to this in
use
the laser energy that
just will cut through the adhesions
without touching the stapes at all.
So we're able to remove some of the scar tissue without touching
those delicate parts of the inner ear. I think it's a very good tool
for doing all sorts of dissections of soft tissue within the middle ear.
It is very accurate because you can put the tip of the instrument exactly where you want,
change the angles and deliver precise amounts of cutting energy or coagulation
throughout the middle ear.
It will be very helpful in general ear surgery for these situations where you
want to remove scar tissue without causing any damage to the surrounding structures.