CO2 laser for otosclerosis: safe energy parameters

Area of Science:

• Otolaryngology
• Surgical Technology
• Laser Medicine

Background:

• Otosclerosis surgery, including stapedotomy and stapedectomy, requires precise energy delivery.
• The CO2 laser offers potential benefits but necessitates careful energy parameter selection to avoid inner ear damage.

Purpose of the Study:

• To establish safe energy parameters for Sharplan CO2 laser models (734, 1040, 1100A) in otosclerosis surgery.
• To evaluate the thermal effects and clinical safety of CO2 laser use during stapedotomy and stapedectomy revisions.

Main Methods:

• Laboratory determination of safe energy settings using pyroelectric detectors.
• Measurement of vestibular temperature changes with a thermocouple during simulated stapedotomy and stapedectomy revisions.
• Clinical application in over 200 otosclerosis patient surgeries under local anesthesia.

Main Results:

• Established safe energy settings for Sharplan CO2 laser models, limiting vestibular temperature rise to ≤0.3°C for stapedotomy and ≤0.5°C for stapedectomy.
• No intraoperative dizziness reported in over 200 patients when laser was applied to the stapes footplate or oval window neomembrane.
• No significant sensorineural hearing loss in the speech range observed post-operatively.

Conclusions:

• The defined CO2 laser energy parameters are safe for stapedotomy and stapedectomy revisions in otosclerosis.
• These settings minimize thermal effects on the inner ear, ensuring patient safety and preserving hearing function.
• The CO2 laser is a viable and safe tool for otosclerosis surgical interventions.