First experience with the fiber-enabled CO2 laser in stapes surgery and a comparison with the "one-shot" technique.
OBJECTIVE
To compare bone conduction after fiber-enabled CO2 laser perforation of the stapes footplate with conduction after the "one-shot" technique during stapedotomy in patients with otosclerosis.


METHODS
Retrospective clinical study.


METHODS
Tertiary reference center.


METHODS
We evaluated data from 178 patients who had undergone primary stapedotomy for suspected stapedial ankylosis. The stapes footplate was perforated using a fiber-enabled CO2 laser in 89 patients and the "one-shot" technique in the other 89. Only consecutive surgery was considered. Bone conduction thresholds were determined at 0.5, 1, 2, and 4 kHz on the first and third postoperative days in all patients; 172 patients were followed up after 1 month. Audiograms were compared with preoperative bone conduction.


RESULTS
The postoperative bone conduction threshold on Day 1 was significantly worse at almost all frequencies. At 0.5 and 2 kHz, it improved within a month and was significantly different from the preoperative value. Bone conduction threshold at 4 kHz showed the greatest deterioration immediately after surgery, improving considerably in 1 month but remaining worse than at baseline. Only at 1 kHz was there no significant immediate hearing loss. Direct comparison of the fiber-enabled CO2 laser and the "one-shot" technique showed no statistically significant differences.


CONCLUSIONS
Compared with the "one-shot" technique, the fiber-enabled CO2 laser can be used safely in stapes surgery, without great risk to the patient. In our opinion, it has practical advantages, especially in difficult anatomic conditions.
*Department of Otorhinolaryngology, Head and Neck Surgery, and †Institute of Medical Information Technology, Biometry and Epidemiology, University of Erlangen-Nuremberg, Erlangen, Germany.
Christoph
C
Brase
Judith
J
Schwitulla
Julian
J
Künzel
Thomas
T
Meusel
Heinrich
H
Iro
Joachim
J
Hornung
D000328:Adult; D001844:Bone Conduction / Q000502:physiology*; D005260:Female; D006801:Humans; D054020:Lasers, Gas; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome