title: Safety of the erbium:yttrium-aluminum-garnet laser in stapes surgery in otosclerosis.
abstract: OBJECTIVE
  The purpose of this study was to present early and late bone-conduction hearing thresholds and data about cochlear and vestibular disturbances in patients after erbium:yttrium-aluminum-garnet (Er:YAG) laser stapedotomy in otosclerosis.
  
  
  METHODS
  The study design was a retrospective study.
  
  
  METHODS
  The study was conducted at an academic tertiary referral center.
  
  
  METHODS
  In this study, audiologic data of 117 patients undergoing Er:YAG laser-assisted stapedotomy for otosclerosis between 1993 and 1999 were included.
  
  
  METHODS
  The preoperative minus 2 postoperative (early, 1-3 days; late, at least 6 weeks) average pure-tone bone-conduction thresholds at 1, 2, and 4 kHz and 0.5, 1, 2, and 3 kHz were calculated. The postoperative appearance of nystagmus, vertigo, and tinnitus was analyzed.
  
  
  RESULTS
  A total of 91 of 117 patients showed unchanged preoperative minus postoperative pure-tone bone-conduction averages at 1, 2, and 4 kHz in the late postoperative measurement. A slight deterioration was observed in 8 of 117 patients. Regarding the frequencies 0.5, 1, 2, and 3 kHz, 97 of 117 patients showed unchanged preoperative minus postoperative pure-tone bone-conduction averages. A new transient tinnitus appeared in 37 of 117 patients, and a new persistent tinnitus was found in 3 of 117 patients. Most of the patients had no postoperative dizziness (63/117 patients) and no postoperative nystagmus (109/117 patients).
  
  
  CONCLUSIONS
  The study did not show significant sensorineural hearing loss at or below 3 kHz. Vestibular and cochlear function has no clinically relevant suppression after Er:YAG laser stapedotomy.
authors.affiliation: Department of Otorhinolaryngology, University of Ulm, Ulm, Germany. tilman.keck@medizin.uni-ulm.de
authors.forename: T
authors.initials: T
authors.lastname: Keck
authors.forename: M
authors.initials: M
authors.lastname: Wiebe
authors.forename: G
authors.initials: G
authors.lastname: Rettinger
authors.forename: H
authors.initials: H
authors.lastname: Riechelmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000535:Aluminum / Q000009:adverse effects*; D001309:Auditory Threshold / Q000502:physiology; D001844:Bone Conduction / Q000502:physiology; D002648:Child; D003051:Cochlea / Q000503:physiopathology; D004871:Erbium / Q000009:adverse effects*; D006314:Hearing Loss, Conductive / Q000175:diagnosis; D006801:Humans; D053685:Laser Therapy; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000175:diagnosis / Q000209:etiology; D010040:Otosclerosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013201:Stapes Surgery; D014012:Tinnitus / Q000175:diagnosis / Q000209:etiology; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology; D014722:Vestibule, Labyrinth / Q000503:physiopathology; D015019:Yttrium / Q000009:adverse effects*
chemical_list: D015019:Yttrium; D004871:Erbium; D000535:Aluminum