Continuous cooling system in conjunction with laser surgery for ear reshaping.
Abstract
When the cartilage on the prominent ears is reshaped, the arising stress returns the tissue to its initial configuration. Laser irradiation of areas of maximal stress leads to stress relaxation and results in a stable configuration. Sixty auricles were harvested from 30 New Zealand white rabbits and cut into a rectangle measuring 50 mm by 25 mm with an average thickness of approximately 1.3 mm. Bilateral skin was included for ex vivo studies. Continuous cryogen spray cooling (CSC) with laser energy was delivered to the exposed cartilage for reshaping. In clinical applications, from January 2006 to December 2016, a total of 50 patients with 100 bat ears who underwent CO 2 laser reshaping (otoplasty) were assessed. A continuous cooling system (4 °C) in conjunction with a CO 2 laser was applied to make a retroauricular-approached incision and reshape the ear cartilage. The well cartilage bending correlated with the different parameters demonstrated in the continuous CSC protected group. All 100 (100%) of the subjects experienced early complications (≤ 1 month) related to laser exposure with swelling, while 5 (5%) experienced ecchymosis, 2 (2%) minimal hematoma, 2 (2%) scarring, 1 (1%) minor infection, 1 (1%) under correction, 1 (1%) overcorrection, and 1 (1%) relapse. These problems were corrected and/or had resolved after 3 months. All patients achieved good to excellent results in our final outcome assessment (> 6 months). Laser reshaping has a potential use in certain surgical procedures involving the cartilage. The appropriate conditions for laser ear reshaping clearly depend on the laser wavelength used, energy controlling, and tissue optical properties.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A 2020 study combining laser with cryogen cooling further improved satisfaction and outcomes.
“A 2020 study combining laser with cryogen cooling further improved satisfaction and outcomes.56”
From Otoplasty Surgical Techniques and Clinical Outcomes: A Practical Review (2026) · cites this paper as [56]
Cites
Moritz, A. R., & Henriques, F. C. (1947) · PubMed · Cited by 1,198 · see citing works
A Form of Heat-Conduction Equations Which Eliminates the Paradox of Instantaneous Propagation
Cattaneo, C. (1958) · Medical Entomology and Zoology · Cited by 800 · see citing works
Experimental Evidence of Hyperbolic Heat Conduction in Processed Meat
Mitra, K., Kumar, S., Vedevarz, A., & Moallemi, M. K. (1995) · ASME Journal of Heat and Mass Transfer · doi:10.1115/1.2822615 · Cited by 672 · see citing works
Hyperbolic Heat Conduction Equation for Materials With a Nonhomogeneous Inner Structure
Kamiński, W. (1990) · ASME Journal of Heat and Mass Transfer · doi:10.1115/1.2910422 · Cited by 526 · see citing works
Relationship between pain and tissue damage due to thermal radiation
Stoll, A. M., & Greene, L. C. (1959) · Journal of Applied Physiology · doi:10.1152/jappl.1959.14.3.373 · Cited by 328 · see citing works
Dynamic Epidermal Cooling During Pulsed Laser Treatment of Port-Wine Stain
Nelson, J. S. (1995) · Archives of Dermatology · doi:10.1001/archderm.1995.01690180071013 · Cited by 319 · see citing works
A Finite Element Model of Skin Subjected to a Flash Fire
Torvi, D. A., & Dale, J. D. (1994) · Journal of Biomechanical Engineering · doi:10.1115/1.2895727 · Cited by 287 · see citing works
The CFC-Ozone Issue: Progress on the Development of Alternatives to CFCs
Manzer, L. E. (1990) · Science · doi:10.1126/science.249.4964.31 · Cited by 259 · see citing works
Chang, C., & Nelson, J. S. (1999) · Dermatologic Surgery · doi:10.1046/j.1524-4725.1999.99100.x · Cited by 184 · see citing works
Chilling Port Wine Stains Improves the Response to Argon Laser Therapy
Gilchrest, B. A., Rosen, S., & Noe, J. M. (1982) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-198202000-00017 · Cited by 151 · see citing works
Continuous wave laser ablation of tissue: analysis of thermal and mechanical events
LeCarpentier, G. L., Motamedi, M., McMath, L. P., Rastegar, S., & Welch, A. J. (1993) · IEEE Transactions on Biomedical Engineering · doi:10.1109/10.212059 · Cited by 96 · see citing works
Chang, C., Kelly, K. M., van Gemert, M. J. C., & Nelson, J. S. (2002) · Lasers in Surgery and Medicine · doi:10.1002/lsm.10102 · Cited by 92 · see citing works
Geronemus, R. G., Quintana, A. T., Lou, W. W., & Kauvar, A. N. B. (2000) · Archives of Dermatology · doi:10.1001/archderm.136.7.942 · Cited by 89 · see citing works
Sobol, E. N., Sviridov, A. P., Omelchenko, A. I., Bagratashvili, V. N., Kitai, M. S., Harding, S. E., Jones, N. H., Jumel, K., Mertig, M., Pompe, W., et al. (2000) · Biotechnology and Genetic Engineering Reviews · doi:10.1080/02648725.2000.10648005 · Cited by 87 · see citing works
Cool Laser Optics Treatment of Large Telangiectasia of the Lower Extremities
Chess, C., & Chess, Q. (1993) · The Journal of Dermatologic Surgery and Oncology · doi:10.1111/j.1524-4725.1993.tb03331.x · Cited by 86 · see citing works
Lu, W., Liu, J., & Zeng, Y. (1998) · Engineering Analysis with Boundary Elements · doi:10.1016/s0955-7997(98)00039-3 · Cited by 73 · see citing works
Chang, C.-J., Anvari, B., & Nelson, J. S. (1998) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-199808000-00029 · Cited by 54 · see citing works
Cryogen Spray Cooling and Pulsed Dye Laser Treatment of Cutaneous Hemangiomas
Chang, C.-J., Kelly, K. M., & Nelson, J. S. (2001) · Annals of Plastic Surgery · doi:10.1097/00000637-200106000-00001 · Cited by 51 · see citing works
Liu, J. (2001) · Journal of Biomechanics · doi:10.1016/s0021-9290(01)00134-8 · Cited by 50 · see citing works
Interpretation of living tissue's temperature oscillations by thermal wave theory
Ren, Z.-P. (1995) · Cited by 46 · see citing works
Feedback-Controlled Laser-Mediated Cartilage Reshaping
Wong, B. J. F., Milner, T. E., Sobol, A., & Nelson, J. S. (1999) · Archives of Facial Plastic Surgery · doi:10.1001/archfaci.1.4.282 · Cited by 45 · see citing works
MAGARIBUCHI, T., Ito, Y., & Kuriyama, H. (1973) · The Journal of General Physiology · doi:10.1085/jgp.61.3.323 · Cited by 44 · see citing works
The histology of laser thermo-chondro-plasty.
Helidonis, E. S., Volitakis, M., Naumidi, I., Velegrakis, G., Bizakis, J., & Christodoulou, P. (1994) · American Journal of Otolaryngology · doi:10.1016/0196-0709(94)90083-3 · Cited by 40 · see citing works
The Benefit of Chilling in Argon-Laser Treatment of Port-Wine Stains
Dréno, B., Patrice, T., Litoux, P., Barriere, H., & Dréno, B. (1985) · Plastic & Reconstructive Surgery · doi:10.1097/00006534-198501000-00009 · Cited by 40 · see citing works
Analysis of tissue injury by burning: comparison of in situ and skin flap models
Diller, K. R., & Hayes, L. J. (1991) · International Journal of Heat and Mass Transfer · doi:10.1016/0017-9310(91)90283-k · Cited by 35 · see citing works
Laser-assisted cartilage reshaping: in vitro and in vivo animal studies
Wang, Z., Pankratov, M. M., Perrault, D. F., & Shapshay, S. M. (1995) · Proceedings of SPIE, the International Society for Optical Engineering/Proceedings of SPIE · doi:10.1117/12.209113 · Cited by 26 · see citing works
In Vitro Ear Cartilage Shaping with Carbon Dioxide Laser an Experimental Study
Velegrakis, G., Papadakis, C., Nikolidakis, A., Prokopakis, E., Volitakis, M. E., Naoumidi, I., & Helidonis, E. (2000) · Annals of Otology, Rhinology and Laryngology · doi:10.1177/000348940010901215 · Cited by 23 · see citing works
Estimation of Surface Absorptivity and Surface Temperature in Laser Surface Hardening Process
Sun, Y.-S., Weng, C., Chen, T.-C. C. T.-C., & Li, W.-L. (1996) · Japanese Journal of Applied Physics · doi:10.1143/jjap.35.3658 · Cited by 21 · see citing works
Effects of microwave heating on the thermal states of biological tissues
Nabil, T. M. E.-D., Mona, A. A. M., & Asma., F. E.-S. (2003) · AFRICAN JOURNAL OF BIOTECHNOLOGY · doi:10.5897/ajb2003.000-1091 · Cited by 19 · see citing works
Stark, H. H. (1991) · Laryngo-Rhino-Otologie · doi:10.1055/s-2007-998117 · Cited by 16 · see citing works
Huang, P. S., & Chang, C. (2001) · PubMed · Cited by 11 · see citing works
Chang, C., Cheng, S. M. H., Chiu, L. L., Wong, B. J. F., & Ting, K. (2008) · Lasers in Surgery and Medicine · doi:10.1002/lsm.20652 · Cited by 9 · see citing works
Prediction of Skin Temperature Distribution in Cosmetic Laser Surgery
Ting, K., Chen, K.-T., Cheng, S.-F., Lin, W.-S., & Chang, C.-R. (2008) · Japanese Journal of Applied Physics · doi:10.1143/jjap.47.361 · Cited by 8 · see citing works
Chang, C., Chang, S.-Y., Chen, K.-T., Hou, K.-H., Yu, D.-Y., Hsiao, Y., & Ting, K. (2015) · Biomedical Journal · doi:10.4103/2319-4170.148903 · Cited by 5 · see citing works
Dynamic cooling for laser photocoagulation: In vivo & ex vivo studies
Chang, C. J., Tzeng, Y.-F., & Fu, W. (2002) · Journal of Medical and Biological Engineering · Cited by 5 · see citing works
Chang, C.-J., Tsang, K.-L., Chiu, L.-L., & Wong, B. J. F. (2004) · Formosan Journal of Surgery · doi:10.29833/fjs.200402.0002 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Repopulation of decellularised articular cartilage by laser-based matrix engraving
Nürnberger, S., Schneider, C., Keibl, C., Schädl, B., Heimel, P., Monforte, X., Teuschl, A., Nalbach, M., Thurner, P. J., Grillari, J., et al. (2021) · EBioMedicine · doi:10.1016/j.ebiom.2020.103196 · Cited by 25 · see citing works
Zhu, Y., Peng, X., Zhou, X., Li, H., WIN, K., Wang, H., Guo, Z., Xiong, Y., Xu, J., Qi, X., et al. (2023) · Journal of Biophotonics · doi:10.1002/jbio.202300443 · Cited by 3 · 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
“56 LACR offers smoother contours, reduced scar-ring, and potential applications in pediatric otoplasty and other cartilage corrections.”
- Authors
- Hsiao, Y.-C., Ting, K., Su, Y.-L., & Chang, C.-J.
- Affiliations
- Chang Gung University (TW)
- Lunghwa University of Science and Technology (TW)
- National Chung Hsing University (TW)
- Corresponding author
- Chang, Cheng-Jen
- Venue
- Lasers in Medical Science
- Published
- 2019-07-01
- Volume
- 35
- Issue
- 2
- Pages
- 387-393
- ISSN
- 0268-8921 (ISSN-L)
- 1435-604X
- OpenAlex
- W2954842577
- Cited by
- 3
- References
- 36
- Citations by year
- 2026: 1 · 2023: 1 · 2021: 1
- FWCI
- 0.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Lasers in Medical Science (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Reconstructive Facial Surgery Techniques
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Dermatology › Dermatologic Treatments and Research
- Keywords
- otoplasty, prominent ears, CO2 laser, stress relaxation, auricle, postoperative complications
- MeSH terms
- Adolescent, Adult, Animals, Cicatrix, Cold Temperature, Ear, Ear Cartilage, Female, Humans, Longitudinal Studies, Male, Rabbits, Skin, Plastic Surgery Procedures, Laser Therapy, Lasers, Gas, Ear Auricle, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
