Objective: To apply CO2 laser assisted Ugo Fisch stapedotomy with artificial stapes prostheses and to observe its outcome.
Method: Between October 2001 and June 2003, 24 patients with clinical diagnosis of otosclerosis were performed with CO2 laser assisted Ugo Fisch stapedotomy. Among them 14 were males and 10 were females with a age of 24-65 years (averaged 36.5 years). The preoperative air bone gap of speech frequency is 25.00 to 48.25 dB, with an average of 36.25 dB. Follow-up was done once two months until 6 months. The key techniques are: (1) first disarculate the incudostapedial joint; (2) 0.3 mm or 0.4 mm piston is selected according to the space between horizontal segment of facial nerve and the suprastructure of stapes; (3) fenestrate on the footplate, insert the piston before dealing with stapedial muscle tendon and suprastructure of stapes; (4) deal with stapedial muscle tendon and suprastructure of stapes with CO2 laser.
Result: A postoperative air bone gap < or = 15 dB is achieved in 23 cases (95.8%), a postoperative air bone gap < or = 10 dB is achieved in 21 cases (87.5%), with a mean of 8.5 dB. The postoperative complication is slight, without sickness and vomit, and 22 patients could walk immediately after surgery.
Conclusion: CO2 laser assisted stapedotomy is the first choice for treating otosclerosis, which is of significant outcome, high safety and slight postoperative complication.