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Updated: Jun 13, 2025

Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach
Published on: March 5, 2022
Preliminary Outcomes of the 445-nm Blue Light Laser for Stapedotomy
Objective:
To evaluate the efficacy of the 445-nm blue light laser in stapedotomy, compared with the CO 2 laser.
Patients:
Patients 18 years or older with a history of otosclerosis who underwent stapedotomy with either carbon dioxide (CO 2 ) or blue light (BL) laser from September 2020 to May 2024. Patients who had revision surgery, underwent stapedotomy without the use of CO 2 or BL laser, or were without an available preoperative or postoperative audiogram were excluded.
Intervention:
Stapedotomy with the 445-nm BL laser.
Main Outcome Measure:
Postoperative improvement in air-bone gap (ABG) on audiogram for patients who underwent stapedotomy with BL laser, as compared with those who underwent stapedotomy with CO 2 laser.
Results:
Thirty-two patients were included in the final cohort, with 16 patients in the CO 2 laser and BL laser groups, respectively. Although there was no significant difference in the postoperative ABG between the CO 2 and BL laser groups (9.1 versus 6.5 dB, p = 0.27), there was a difference in the number of footplate fractures between the CO 2 and TB laser groups, although this neither was significant (0 versus 3 events, p = 0.23) nor impacted hearing status.
Conclusion:
The BL laser offers comparable closure of the ABG in stapes surgery, as well as a similar safety profile, when compared with the CO 2 laser.

