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The new methods for modeling of costal cartilage implants for laryngotracheal defect treatment
O. Baum1, Y. Alexandrovskaya1, V. Svistushkin2, E. Sobol3
1Federal Scientific Research Centre 'Crystallography and Photonics' of Russian Academy of Sciences, Institute of Photon Technologies, Troitsk- Moscow, Russian Federation 2I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation 3Arcuo Medical Inc, Arcuo Medical Inc, Incline Village, USA
Thermo-mechanical effect of laser radiation is a basis for the new methods for modeling of costal cartilage implants of a given shape. In larynx surgery the prospects of the technique are connected with preparation of implants of the proper semicircle -shape. If the final shape of an implant is formed with a surgical scalpel, residual stresses lead to the distortion of the implant. This decreases its survivability after the surgery. Laser-induced stress relaxation in the cartilage implants without disturbing tissue functionality opens new possibilities for implantology.
Studies of the effects of pulsed laser radiation on porcine [1], rabbit [2] and finally, on human [3] cartilages were carried out using a 1.56 p,m IR-laser. A theoretical model predicting the laser mode allowed establishing optimal laser setting have been constructed on the basis of thermal-conductivity equation and thermal-stress theory. The location of the maximum laser-induced alteration in the structure of biological tissue was shown using the thermal stress tensor.
The results of this theoretical calculation obtained for porcine and rabbit cartilages showed the possibility of transferring the theoretical approach from the animal cartilage to the isolated human cartilage.
The implantation of the laser-shaped semicircle cartilage during the operation for closing the human laryngotracheal defect has been done. The stability of post operational results has been obtained during 16 months follow-up.
The study was supported by the Russian Foundation for Basic Research (Project No. 18-2902124).
References
[1] O. I. Baum, Yu. M. Alexandrovskaya, V. M. Svistushkin, et.al. Laser Phys. Lett., 16, 035603 (2019).
[2] E. Sobol, O. Baum, Yu. Alexandrovskaya, et.al. Proc. of SPIE Vol 10039, 100390U-1 (2017).
