[Cochlear protection and surgical precision in stapedotomy with Er:YAG laser].
BACKGROUND
Using laser in stapedotomy has attracted a lot of attention since the nineties. It aims at minimizing complications due to hand-operated equipment, especially inner ear lesions, and achieving higher precision. We analyzed the clinical effect of Er:YAG laser with the question whether the postulated cochlea protection and foot plate perforation, optimized for better sound conduction, are achieved, compared to conventional stapedotomy.


METHODS
We evaluated retrospectively audiometrical data including pre- and postoperative bone and air conduction thresholds of 114 consecutive patients, on whom we had performed stapedotomy and had inserted platinum-teflon prostheses. The intervention was done conventionally in 72 cases and in 42 cases with Er:YAG laser.


RESULTS
In the lower and middle frequencies, laser technique resulted in a more pronounced improvement of bone conduction thresholds compared to conventional stapedotomy. The improvement of air conduction was more distinct in ears after laser surgery; also, the difference between air and bone conduction was reduced at a higher degree.


CONCLUSIONS
Er:YAG laser in stapedotomy is coupled with cochlea protection, as demonstrated under clinical conditions, and allows higher hearing benefit of air conduction compared to conventional stapedotomy. Our results emphasize the impact of innovative laser technique on stapedotomy.
Klinik für Hals-, Nasen- und Ohren-Heilkunde, Universitätsklinikum Freiburg i. Br. maier@hno1.ukl.uni-freiburg.de
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Maier
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PU
Lohnstein
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Klenzner
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Schipper
D000328:Adult; D000368:Aged; D001299:Audiometry; D001844:Bone Conduction; D003051:Cochlea / Q000502:physiology; D003627:Data Interpretation, Statistical; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000601:surgery*; D010984:Platinum; D011138:Polytetrafluoroethylene; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome
D010984:Platinum; D011138:Polytetrafluoroethylene