Functional results in stapedotomy with and without CO(2) laser

Area of Science:

• Otolaryngology
• Surgical Technology
• Audiology

Background:

• Otosclerosis is a common cause of conductive hearing loss.
• Stapedotomy is a surgical procedure to restore hearing in otosclerosis patients.
• Traditional microdrill techniques for stapedotomy have known limitations.

Purpose of the Study:

• To evaluate the efficacy and safety of CO(2) laser-assisted stapedotomy.
• To compare laser stapedotomy outcomes with traditional microdrill methods.
• To assess the impact of CO(2) laser on cochlear reserve and inner ear function.

Main Methods:

• A comparative study involving 451 otosclerosis patients operated between 1996-2000.
• Group 1 (169 patients): Primary stapedotomy using a microdrill for footplate perforation.
• Group 2 (282 patients): Primary stapedotomy using a CO(2) laser for platinotomy, with adjustable spot size.

Main Results:

• Significantly higher proportion of patients (282) achieved cochlear reserve closure within 10 dB using the CO(2) laser compared to the microdrill group (169).
• The CO(2) laser created smooth-edged perforations, facilitating prosthesis fitting.
• No cases of postoperative anacusis (total hearing loss) or severe vertigo were reported in the laser group, indicating enhanced inner ear safety.

Conclusions:

• CO(2) laser stapedotomy is a safe and effective technique for treating otosclerosis.
• The laser method demonstrates superior functional hearing results compared to the microdrill.
• The technique's safety profile for the inner ear is confirmed, supporting its clinical validity.