"Hot" vs "Cold" endoscopic stapes surgery: a matched case-control study

Area of Science:

• Otolaryngology
• Surgical Innovation
• Audiology

Background:

• Otosclerosis is a common cause of conductive hearing loss.
• Stapes surgery is a standard treatment for otosclerosis.
• Advancements in surgical technology offer new approaches to stapes surgery.

Purpose of the Study:

• To compare hearing results and complication rates of endoscopic stapes surgery (ESS) for otosclerosis.
• To evaluate the efficacy of CO2 fiber laser versus microdrill techniques in ESS.

Main Methods:

• A case-control study matched patients based on year of surgery, preoperative air-bone gap, sex, and age.
• Audiological data and complication rates were compared between CO2 fiber laser ESS and traditional microdrill ESS groups.
• 46 patients undergoing ESS for otosclerosis were included.

Main Results:

• Operative time was longer for the CO2 fiber laser group (65 min) compared to the microdrill group (45 min).
• Both groups showed similar postoperative air-conduction pure-tone averages (AC-PTA).
• The laser group exhibited higher high-frequency bone conduction and improved BC-PTA at 2000 Hz, suggesting a potential overclosure effect.

Conclusions:

• Endoscopic stapes surgery (ESS) is a safe and effective treatment for otosclerosis.
• Both CO2 fiber laser and microdrill techniques yield similar functional hearing outcomes.
• The choice of technique in ESS does not significantly impact overall safety or efficacy.