[Comparison of microdrill versus diode laser in endoscopic stapedotomy]

Objective: To compare the surgical time, auditory outcomes and safety between microdrill and diode laser in endoscopic stapedotomy. Methods: The data of patients with otosclerosis who underwent endoscopic stapedotomy in Eye and ENT Hospital of Fudan University from January 2020 to December 2023 were retrospectively analyzed. The patients were divided into microdrill group and laser group according to treatment method. Surgical time, hearing level and complications were compared between the two groups. Results: A total of 148 patients (41 males and 107 females) aged (42.8±7.7) years were included. There were 81 cases in the microdrill group and 67 cases in the laser group, respectively. No statistically significant differences in age, gender, duration of disease and surgical side were detected between the two groups (all P>0.05). Preoperative air-bone gap (ABG) was (27.0±5.5) decibel hearing level (dB HL) in microdrill group and (25.0±5.1) dB HL in laser group, with no statistically significant difference (P=0.191). Postoperative ABG was (14.0±2.6) dB HL and (12.1±2.7) dB HL in microdrill group and laser group, respectively, and there was no statistically significant difference between the two groups (P=0.595). Compared with preoperative results, postoperative ABG decreased in both groups (both P<0.05). Postoperative vertigo was observed in 7 patients (8.6%) in the microdrill group and 6 patients (9.0%) in the laser group, respectively (P=0.947). The surgical time in microdrill group [(53.0±9.0) min] was shorter than that in laser drilling group [(59.3±12.8) min] (P<0.001). Conclusion: Postoperative improvement in hearing level after microdrill is similar to diode laser, but microdrill has shorter surgical time.