The Erbium:YAG laser ((lambda) equals 2.94 micrometer) has been suggested for use in dental, orthopedic, and middle ear surgery due to decreased thermal trauma, precise ablation characteristics, and potential fiber optic delivery. While there has been much focus on the thermal and photoacoustic events that occur during pulsed laser ablation of hard tissue, there are few studies that examine the acoustic energy generated by these devices during ablation from an audiologic standpoint. In this study, the porcine otic capsule, nasal bone, and teeth were irradiated with an Erbium:YAG laser. Frequencies of 5 and 10 Hz shot repetition rate were used with .5 to 4 W average power. Additionally, a burst mode consisting of three pulses was used with .2 to 1.4 J total energy. During ablation, acoustic measurements were made using a sound level meter held 20 mm away from the target site. A constant spot size of 500 micrometer was maintained for each laser blast. With each set of laser parameters, the sound intensity (dB SPL) exceeded 70 dB. Peak intensity measurements of 95 dB were measured. The clinical significance of these findings is discussed and the acoustical aspects of middle ear function and noise trauma are reviewed.
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