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Continuous cooling system in conjunction with laser surgery for ear reshaping

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Abstract

When the cartilage on the prominent ears is reshaped, the arising stress returns the tissue to its initial configuration. Laser irradiation of areas of maximal stress leads to stress relaxation and results in a stable configuration. Sixty auricles were harvested from 30 New Zealand white rabbits and cut into a rectangle measuring 50 mm by 25 mm with an average thickness of approximately 1.3 mm. Bilateral skin was included for ex vivo studies. Continuous cryogen spray cooling (CSC) with laser energy was delivered to the exposed cartilage for reshaping. In clinical applications, from January 2006 to December 2016, a total of 50 patients with 100 bat ears who underwent CO2 laser reshaping (otoplasty) were assessed. A continuous cooling system (4 °C) in conjunction with a CO2 laser was applied to make a retroauricular-approached incision and reshape the ear cartilage. The well cartilage bending correlated with the different parameters demonstrated in the continuous CSC protected group. All 100 (100%) of the subjects experienced early complications (≤ 1 month) related to laser exposure with swelling, while 5 (5%) experienced ecchymosis, 2 (2%) minimal hematoma, 2 (2%) scarring, 1 (1%) minor infection, 1 (1%) under correction, 1 (1%) overcorrection, and 1 (1%) relapse. These problems were corrected and/or had resolved after 3 months. All patients achieved good to excellent results in our final outcome assessment (> 6 months). Laser reshaping has a potential use in certain surgical procedures involving the cartilage. The appropriate conditions for laser ear reshaping clearly depend on the laser wavelength used, energy controlling, and tissue optical properties.

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Acknowledgments

Our research has been supported by the grants of the Chang Gung Memorial Hospital (CMRPG 3E0581, 3E0221, 3E1151). The authors would like to express their sincere gratitude to Dr. Lin Chu M.D. and Prof. Brian Wong, M.D., Ph.D., F.A.C.S., Beckman Laser Institute at the University of California at Irvine for providing his theoretical perspective and medical expertise to assist in the research.

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Correspondence to Cheng-Jen Chang.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Hsiao, Y., Ting, K., Su, Y. et al. Continuous cooling system in conjunction with laser surgery for ear reshaping. Lasers Med Sci 35, 387–393 (2020). https://doi.org/10.1007/s10103-019-02831-3

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Keywords

  • Rabbit ear
  • Cryogen spray cooling
  • Laser reshaping
  • Thermal injury