Minimally invasive ear reshaping with a 1450-nm diode laser using cryogen spray cooling in New Zealand white rabbits.
Open accessAbstract
Otoplasty is the current standard of care for treating prominent ears, a psychologically and sometimes functionally disabling disorder. The technically demanding procedure carries many risks such as poor aesthetic outcome, need for revision surgery, and need for general anesthesia. This study investigates the use of laser irradiation combined with cryogen skin cooling and stenting to reshape cartilage in the ears of New Zealand white rabbits. In this prospective, randomized, internally controlled animal study, the right ears of 9 rabbits were mechanically deformed with a jig and then irradiated with a 1450-nm diode laser combined with cryogen skin cooling (14 J/pulse with cryogen spray for 33 milliseconds per cycle and a 6-mm spot size). The left ear served as the control. The ears were splinted for 1, 3, or 4 weeks. The rabbits were then given a lethal dose of intravenous pentobarbital, and the splints were removed and ears examined and photographed. Light and confocal microscopy were performed on the specimens. Shape change was observed in all 9 treated rabbit ears, while none of the control ears (stenting alone) showed significant change. Qualitatively, reshaped ears were stiffer after 4 weeks of splinting than after 1 or 3 weeks. None of the rabbits showed evidence of skin injury nor did they show signs of postprocedural pain. Findings from histologic analysis in the treated areas showed evidence of an expanded chondrocyte population in the region of laser irradiation, along with some perichondrial thickening and some fibrosis of the deep dermis. Confocal microscopy revealed minimal cellular death at 1 week and none thereafter. Cartilage reshaping using laser energy can be performed safely transcutaneously using cryogen spray cooling in rabbits. This animal model has similarity to human ears with regard to skin and cartilage thickness and is a stepping stone toward developing minimally invasive laser auricle reshaping in humans.
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Transcutaneous laser cartilage reshaping using a 1450-nm diode laser and cryogen spray cooling preserved cartilage viability.
“Transcutaneous laser cartilage reshaping using a 1450-nm diode laser and cryogen spray cooling preserved cartilage viability,44”
From Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review (2026) · cites this paper as [44]
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Advanced Study of Spray Cooling: From Theories to Applications
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“In 2009, Holden et al. [164] combined CSC technology with a 1450 nm diode laser to perform ear plastic surgery on live New Zealander rabbits, and proved that laser energy can be safely used to shape rabbit cartilage through CSC.”
MethodNeedle Electrode-Based Electromechanical Reshaping of Cartilage
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BackgroundIn Vivo Needle-Based Electromechanical Reshaping of Pinnae: New Zealand White Rabbit Model
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“[22] achieved reshaping in their respected animal studies within 1 week, an extended splinting duration was needed in the clinical studies in order to enhance shape change stabilization.”
BackgroundEx Vivo Electromechanical Reshaping of Costal Cartilage in the New Zealand White Rabbit Model
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“and Holden et al.(13) achieved reshaping in their respected animal studies within 1 week, an extended splinting duration was needed in the clinical studies to enhance shape-change stabilization.”
Background1064‐nm N d: YAG laser‐assisted cartilage reshaping for treating ear protrusions
Leclère, F. M., Mordon, S. R., López, J. M. A., Martínez-Carpio, P. A., Vélez, M., & Trelles, M. A. (2015) · The Laryngoscope · doi:10.1002/lary.25294 · Cited by 9 · see citing works
“Although Mordon et al.7 and Holden et al.19 achieved reshaping in their respected animal studies within 1 week, an extended splinting duration was needed in the clinical studies in order to enhance shape change stabilization.”
BackgroundSoshnikova, Y. M., Shekhter, A. B., Игоревна, Б. О., Em, S., Omelchenko, A. I., Лунин, В. В., & Sobol, E. N. (2015) · Lasers in Surgery and Medicine · doi:10.1002/lsm.22331 · Cited by 8 · see citing works
Modular Component Assembly Approach to Microtia Reconstruction
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“using a 1,450 nm wavelength diode laser [25].”
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“cryogen spray cooling, in which the entire chondrocyte population was viable at 30 days post-treatment, but that there was neochondrogenesis (not observed in this current study) [21].”
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“The purpose of this study was to better identify therapy thresholds for laser output energy (E), duration of cryogen spray cooling pulse (Tc), and the number of treatment cycles (N t) that can be used to reshape the ear in vivo with acceptable skin injury using Holden's parameters as a baseline [22].”
InfluentialDermatologic Surgery and Procedures
Vereecken, P. (2018) · InTech eBooks · doi:10.5772/66008 · Cited by 4 · see citing works
Otoplasty outcomes with different suture materials in a rabbit model.
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Method1540 nm-Er/Glass Laser-Assisted Cartilage Reshaping For Protruding Ears (LACR)
Leclère, F. M., Mordon, S. R., & Trelles, M. A. (2016) · Springer eBooks · doi:10.1007/978-1-4939-1758-7_14 · Cited by 3 · see citing works
Study on Application of YAG Laser-Assisted Ear Correction Model to Congenital Auricular Deformities
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CO2 Laser-Assisted Otoplasty: A New Dermatosurgical Procedure
Leal-Silva, H. (2018) · InTech eBooks · doi:10.5772/intechopen.71992 · Cited by 1 · see citing works
“in 2009 published a minimally invasive ear reshaping with a 1450-nm diode laser using cryogen spray cooling in New Zealand white rabbits [20].”
MethodCarbon Dioxide Laser-Assisted Cartilage Reshaping Otoplasty for Prominent Ears
Ragab, A. (2013) · Springer eBooks · doi:10.1007/978-3-642-35431-1_24 · Cited by 1 · see citing works
Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review
Kaleeny, J. D., & Janis, J. E. (2026) · Plastic and Reconstructive Surgery - Global Open · doi:10.1097/gox.0000000000007404
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Gu, J. T., & Wong, B. J. F. (2020) · Lasers in Oral and Maxillofacial Surgery · doi:10.1007/978-3-030-29604-9_13
- Authors
- Holden, P. K., Chlebicki, C., & Wong, B. J. F.
- Affiliations
- University of California, Irvine (US)
- Corresponding author
- Wong, Brian J. F.
- ORCID
- Wong, Brian J. F.
- Venue
- Archives of Facial Plastic Surgery
- Publisher
- SAGE Publications
- Published
- 2009-11-02
- Volume
- 11
- Issue
- 6
- Pages
- 399-404
- ISSN
- 1521-2491 (ISSN-L)
- 1538-3660
- PMC
- PMC3970727
- OpenAlex
- W2149062166
- Cited by
- 26
- References
- 31
- Citations by year
- 2026: 1 · 2025: 1 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 2 · 2016: 2 · 2015: 4 · 2014: 2 · 2013: 5
- FWCI
- 1.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Facial Plastic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Deafness and Other Communication Disorders (DC005572, R03DC005572)
- National Institute of Biomedical Imaging and Bioengineering (P41EB015890)
- National Center for Research Resources (P41 RR01192, P41RR001192)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Laser Applications in Dentistry and Medicine
- Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
- Keywords
- otoplasty, prominent ears, cryogen spray cooling, minimally invasive surgery, splinting, chondrocyte proliferation, rabbit ear model
- MeSH terms
- Administration, Cutaneous, Anesthesia, Local, Animals, Combined Modality Therapy, Ear Cartilage, Ear, External, Immunohistochemistry, Photomicrography, Rabbits, Random Allocation, Wound Healing, Cryotherapy, Microscopy, Confocal, Minimally Invasive Surgical Procedures, Models, Animal, Laser Therapy, Lasers, Semiconductor
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