Potential use of diode laser soldering in middle ear reconstruction

Background and Objectives: To assess the potential use of diode laser soldering to improve mechanical stability of middle ear reconstruction. The diode laser with a biological solder may offer benefits over traditional methods. We evaluated the strength of soldered bonds and a means to apply such a technique in the human middle ear. Study Design/Materials and Methods: The strength of soldered junctions using fascia, cartilage, bone, and hydroxyappatite was evaluated in vitro. A diode laser (810-nm wavelength) and 50% albumin with 0.1% indocyanine green dye was used. Soldered bonds were compared to those obtained with adhesive alone. A fiberoptic delivery system was evaluated. Ten hydroxyappatite prostheses were soldered to the stapes in human cadaver temporal bones, and the force required to disrupt the bonds were measured. Results: Statistically significant greater strength was obtained with soldering. Ossicular prostheses can be effectively secured to the stapes in a cadaver model. Conclusions: Soldering techniques show promise in middle ear reconstruction.