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- Title
Potassium titanyl phosphate laser welding following complete nerve transection.
- Authors
Bhatt, Neel K.; Mejias, Christopher; Kallogjeri, Dorina; Gale, Derrick C.; Park, Andrea M.; Paniello, Randal C.
- Abstract
<bold>Objectives/hypothesis: </bold>Cranial nerve transection during head and neck surgery is conventionally repaired by microsuture reanastomosis. Laser nerve welding (LNW), using CO2 laser to spot-weld the epineurium of transected nerve endings, has been shown in animal models to be a novel alternative to microsuture repair. This method avoids needle/suture material and minimizes instrumentation of the nerve. We hypothesized that potassium titanyl phosphate (KTP) laser would be superior to CO2 laser in repairing transected nerves. Using a rat posterior tibial nerve injury model, we compared CO2 laser, KTP laser, and microsuture reanastomosis.<bold>Study Design: </bold>Animal study.<bold>Methods: </bold>Animals underwent unilateral posterior tibial nerve transection. The injury was repaired by microsuture repair (n = 15), CO2 laser repair (n = 15), or KTP laser repair (n = 15). Weekly walking tracks were performed to measure functional recovery. Nerve segments were harvested for axon counting.<bold>Results: </bold>At 6 weeks, the KTP LNW had the best functional recovery (92.4 ± 8.6%) compared to microsuture repair (84.5 ± 10.2%, difference 7.9%, 95% confidence interval [CI]: 0.84%-14.96%). CO2 laser repair had a functional recovery of 86.8 ± 11.2%. KTP LNW had better axon recovery compared to transection/repair (difference 530.7 axons, 95% CI: 329.9-731.5). Operative time for the microsuture repair was 18.2 ± 6.8 minutes, compared to 5.8 ± 3.7 minutes for the LNW groups (difference 12.4 minutes, 95% CI: 8.6-16.2 minutes).<bold>Conclusions: </bold>KTP, CO2 , and microsuture repair all showed good functional recovery following complete transection of the posterior tibial nerve. Following complete nerve transection during head and neck surgery, KTP LNW may be a novel alternative to microsuture repair.<bold>Level Of Evidence: </bold>NA Laryngoscope, 127:1525-1530, 2017.
- Subjects
POTASSIUM titanyl phosphate; LASER welding; CRANIAL nerves; SURGICAL anastomosis; NERVE endings; WOUNDS &; injuries; SURGERY; TIBIAL nerve surgery; TIBIAL nerve injuries; LASER therapy; ANIMAL experimentation; BIOLOGICAL models; COMPARATIVE studies; MEDICAL lasers; RESEARCH methodology; MEDICAL cooperation; MICROSURGERY; NERVOUS system regeneration; RATS; RESEARCH; SURGICAL complications; EVALUATION research
- Publication
Laryngoscope, 2017, Vol 127, Issue 7, p1525
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1002/lary.26383