title: A meta-analysis review of revision stapes surgery with argon laser: effectiveness and safety.
abstract: OBJECTIVE
  To determine whether there is an advantage in safety and outcome efficacy with the use of argon laser in revision stapes surgery as compared with conventional instruments.
  
  
  METHODS
  A search of the published English-language literature, 1970-1995, was conducted using the following key words: revision, surgery, stapes, laser, stapedotomy, and argon laser.
  
  
  METHODS
  The following inclusion criteria were used to select articles for the meta-analysis: revision cases only, a comprehensive review of intraoperative pathological findings that led to the failure, and accurate documentation by the author, confirmed by our statisticians using a modified chi 2 test. Eleven studies without the use of the laser (n = 1,147 patients) and four studies with the use of the laser (n = 170 patients) including our own patients (n = 23) were entered into the model.
  
  
  METHODS
  The data had to meet strict audiometric criteria, including preoperative and postoperative audiogram pure tone average air-bone gap; postoperative audiograms had to include five classifications, and these audiograms had to be obtained a minimum of 6 months after revision surgery.
  
  
  RESULTS
  A log-linear model was developed for this meta-analysis study, with each study analyzed individually and collectively.
  
  
  CONCLUSIONS
  Revision stapes surgery using the laser demonstrated statistically significant (p = 0.002) advantage in both safety and efficacy over revision procedures using conventional instruments.
authors.affiliation: Clinical Otolaryngology and Neurosurgery, Northwestern University Medical School, Chicago, Illinois, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Wiet
authors.forename: D C
authors.initials: DC
authors.lastname: Kubek
authors.forename: P
authors.initials: P
authors.lastname: Lemberg
authors.forename: A T
authors.initials: AT
authors.lastname: Byskosh
mesh_terms: D001299:Audiometry; D006314:Hearing Loss, Conductive / Q000175:diagnosis; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis; D006801:Humans; D053685:Laser Therapy; D012449:Safety; D013201:Stapes Surgery; D016896:Treatment Outcome