First experience with the fiber-enabled CO2 laser in stapes surgery and a comparison with the "one-shot" technique.

Abstract

OBJECTIVE:

To compare bone conduction after fiber-enabled CO2 laser perforation of the stapes footplate with conduction after the "one-shot" technique during stapedotomy in patients with otosclerosis.

STUDY DESIGN:

Retrospective clinical study.

SETTING:

Tertiary reference center.

MATERIALS AND METHODS:

We evaluated data from 178 patients who had undergone primary stapedotomy for suspected stapedial ankylosis. The stapes footplate was perforated using a fiber-enabled CO2 laser in 89 patients and the "one-shot" technique in the other 89. Only consecutive surgery was considered. Bone conduction thresholds were determined at 0.5, 1, 2, and 4 kHz on the first and third postoperative days in all patients; 172 patients were followed up after 1 month. Audiograms were compared with preoperative bone conduction.

RESULTS:

The postoperative bone conduction threshold on Day 1 was significantly worse at almost all frequencies. At 0.5 and 2 kHz, it improved within a month and was significantly different from the preoperative value. Bone conduction threshold at 4 kHz showed the greatest deterioration immediately after surgery, improving considerably in 1 month but remaining worse than at baseline. Only at 1 kHz was there no significant immediate hearing loss. Direct comparison of the fiber-enabled CO2 laser and the "one-shot" technique showed no statistically significant differences.

CONCLUSION:

Compared with the "one-shot" technique, the fiber-enabled CO2 laser can be used safely in stapes surgery, without great risk to the patient. In our opinion, it has practical advantages, especially in difficult anatomic conditions.

• Authors: Christoph Brase, Judith Schwitulla, Julian Künzel, Thomas Meusel, Heinrich Iro, Joachim Hornung
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 34 Issue 9 Pg. 1581-5 (Dec 2013) ISSN: 1537-4505 [Electronic] United States
• PMID: 24232059 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Bone Conduction (physiology)
• Female
• Humans
• Lasers, Gas
• Male
• Middle Aged
• Otosclerosis (physiopathology, surgery)
• Postoperative Period
• Retrospective Studies
• Stapes Surgery (methods)
• Treatment Outcome