The role of the KTP laser in cholesteatoma surgery.
BACKGROUND
The primary aim in cholesteatoma surgery is the removal of the disease. As a result, most residual disease is found in sites which are both adjacent to the ossicles and hidden from direct view. An ideal instrument should be able to remove disease without movement and should be able to remove disease from regions to which there is no direct access. The laser fullfills this criteria.


METHODS
Ears which underwent canal wall-up cholesteatoma surgery without the laser were compared with ears which underwent surgery which included the KTP laser since 1991.


RESULTS
A total of 514 procedures was analysed (313 without laser and 201 with laser). We obtained respectively 83 (26.5%) and 21 (10.4%) residual disease (P < 0.0001). The procedures involving the KTP laser resulted in no cases of facial nerve injury and no cases of total sensorineural hearing loss.


CONCLUSIONS
We can conclude that the appropriately use of the KTP laser during cholesteatoma surgery does improve significantly the complete removal of disease and presents no extra risk to the vital structures within the temporal bone.
Hamilton
J W
JW
Dept of Otorhinolaryngology, Gloucestershire Royal Hospital, Gloucester, United Kingdom. ymg34@dial.pipex.com
D018424:Cholesteatoma, Middle Ear / Q000601:surgery*; D006801:Humans; D053685:Laser Therapy