Endonasal laser tissue welding: First human experience

Benjamin S. Bleier, Noam A. Cohen, Alexander G. Chiu, Bert W. O'Malley, Laurel Doghramji, James N. Palmer

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Adequate repair of cerebrospinal fluid leak remains a significant challenge in endoscopic skull base surgery. Laser tissue welding (LTW) is a method of creating an instant watertight wound closure using a chromophore doped biological solder, which may be used for cranial base reconstruction. The objective of this study is to assess the safety and technical feasibility of endoscopic LTW in human sinonasal mucosa. Methods: A prospective, Institutional Review Board-approved study was performed of 10 patients undergoing endoscopic LTW using an albumin and hyaluronic acid- based solder for repair of mucosal injuries. Data were collected on patient demographics, total lasing time, and volume of solder used. Wounds were prospectively followed by endoscopic exam and scored on a scale of zero to two by three blinded observers (B.S.B., J.N.P., and A.G.C.) for inflammation, thermal injury, and edema. Results were compared with control wounds using the Mann-Whitney U test. Results: Ten patients (seven men and three women; average age 50 years; range, 33-71 years) underwent endoscopic LTW. Total lasing time was 11 ± 11 minutes requiring 0.96 ± 0.83 mL of solder per patient. Patients were followed for an average of 72 days (range, 12-138 days) and no complications were noted. Solder persisted for up to 26 days and there was no significant difference between the lased and control wounds with regard to inflammation (0.87 ± 0.72 versus 1.31 ± 0.87), thermal injury (0.06 ± 0.25 versus 0.12 ± 0.34), or edema scores (1.13 ± 0.81 versus 1.44 ± 0.73). Conclusion: Endoscopic LTW is a technically feasible and rapid method of wound closure in sinonasal mucosa that does not result in any significant thermal or inflammatory sequelae.

Original languageEnglish (US)
Pages (from-to)244-246
Number of pages3
JournalAmerican Journal of Rhinology and Allergy
Issue number3
StatePublished - May 2010


  • Biologic glue
  • CSF leak repair
  • Endoscopic
  • Laser tissue welding
  • Skull base repair
  • Solder
  • Tissue adhesive

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology


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