[Otosclerosis surgery: a series of 227 cases. Introduction of CO2 laser].
OBJECTIVE
To evaluate the effects of the size of the footplate opening on the hearing results in surgical treatment of otosclerosis and the use of CO2 laser in this indication.


METHODS
190 patients with otosclerosis underwent 227 procedures between 1986 and 1995. Hearing results and symptoms were analyzed to compare the different procedures: 140 stapedectomies, 87 Fisch's stapedotomies, 35 of them with manual perforator, 52 of them with CO2 laser.


RESULTS
Air/bone gap closure within 10 dB was obtained in 87, 92 and 97 percent of stapedectomies and in 80, 84 et 90 percent of stapedotomies after 3 months, 1 and 3 years (NS). Bone conduction was improved in 81, 80 et 63 percent of stapedectomies and 87, 97, 60 percent of stapedotomies after the same time (NS). Air/bone gap closure within 10 dB was obtained in 75 and 80 percent of manual perforator stapedotomies and in 84 and 88 percent of CO2 laser stapedotomies after 3 months, and 1 year (NS). Bone conduction was improved in 78 and 96 percent of manual perforator stapedotomies and 95 and 100 percent of CO2 laser stapedotomies after the same time (NS). No facial palsy or prolonged vertigo occurred. There was one case of anucusis following a stapedectomy.


CONCLUSIONS
Although both stapedectomy and stapedotomy produced equivalent air/bone gap closure, reduction of inner ear trauma was noted with Fisch's stapedotomy. CO2 laser technique is a safe procedure, which optimizes the Fisch's stapedotomy.
Lescanne
E
E
Service ORL et Chirurgie Cervico-Faciale, Hôpital Bretonneau, CHU de Tours. Lescanne@med.univ.tours.pr
Robier
A
A
Soin
C
C
Manceau
A
A
Benlyazid
A
A
Beutter
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies; D013201:Stapes Surgery; D016896:Treatment Outcome
D002245:Carbon Dioxide
Chirurgie de l'otospongiose. A propos de 227 cas introduction de la platinotomie laser CO2.