Conventional approaches versus laser CO2 surgery in stapes surgery: a multicentre retrospective study

Eur Arch Otorhinolaryngol. 2022 May;279(5):2321-2327. doi: 10.1007/s00405-021-06926-y. Epub 2021 Jun 11.

Abstract

Purpose: To analyze and compare surgical and audiological outcomes of conventional approaches versus laser CO2 surgery in stapes surgery.

Methods: 333 patients who underwent stapes surgery were enrolled in the study; the patient population was divided into three groups: group 1: 170 patients treated with conventional stapedotomy with manual microdrill (average age 49.13 years); group 2: 119 patients treated with conventional stapedotomy with electrical microdrill (average age 51.06 years); group 3: 44 patients (average age 50.4 years) who underwent CO2 laser stapedotomy. Intra-operative, postoperative outcomes and audiological results were investigated.

Results: The average surgical time of laser CO2 surgery was longer than for other surgical procedures. No statistical differences emerged in post-operative abnormal taste sensation. There was also no difference in postoperative dizziness. Air-bone gap (ABG) went down from 29.7 ± 10 dB (group 1) and 27.32 ± 9.20 (group 2) to 10 ± 6.9 dB (group 1) and 10.7 ± 6.03 dB (group 2). In group 3 the preoperative ABG was lowered from 28.3 ± 10.1 to 11.8 ± 10.9, with a statistical difference in auditory recovery (p = 0.0001); The group of patients treated with laser CO2 showed a percentage of patients with an ABG closure of between 0 and 10 dB higher than in the group treated with manual microdrills (77.2% vs. 60%, respectively; p = 0.03).

Conclusion: Overall surgical results of CO2 laser and conventional stapedotomy are comparable without any significant difference; however, the group treated with CO2 laser appears to have a percentage of patients with an ABG closure 0-10 dB higher than the group treated using the conventional technique.

Keywords: Laser stapedotomy; Laser stapes surgery; Otosclerosis; Stapedotomy; Stapes; Stapes surgery.

Publication types

  • Multicenter Study

MeSH terms

  • Carbon Dioxide
  • Humans
  • Lasers, Gas* / therapeutic use
  • Middle Aged
  • Otosclerosis* / surgery
  • Retrospective Studies
  • Stapes
  • Stapes Surgery* / methods
  • Treatment Outcome

Substances

  • Carbon Dioxide