Objective: To compare the surgical time, auditory outcomes and safety between microdrill and diode laser in endoscopic stapedotomy. Methods: The data of patients with otosclerosis who underwent endoscopic stapedotomy in Eye and ENT Hospital of Fudan University from January 2020 to December 2023 were retrospectively analyzed. The patients were divided into microdrill group and laser group according to treatment method. Surgical time, hearing level and complications were compared between the two groups. Results: A total of 148 patients (41 males and 107 females) aged (42.8±7.7) years were included. There were 81 cases in the microdrill group and 67 cases in the laser group, respectively. No statistically significant differences in age, gender, duration of disease and surgical side were detected between the two groups (all P>0.05). Preoperative air-bone gap (ABG) was (27.0±5.5) decibel hearing level (dB HL) in microdrill group and (25.0±5.1) dB HL in laser group, with no statistically significant difference (P=0.191). Postoperative ABG was (14.0±2.6) dB HL and (12.1±2.7) dB HL in microdrill group and laser group, respectively, and there was no statistically significant difference between the two groups (P=0.595). Compared with preoperative results, postoperative ABG decreased in both groups (both P<0.05). Postoperative vertigo was observed in 7 patients (8.6%) in the microdrill group and 6 patients (9.0%) in the laser group, respectively (P=0.947). The surgical time in microdrill group [(53.0±9.0) min] was shorter than that in laser drilling group [(59.3±12.8) min] (P<0.001). Conclusion: Postoperative improvement in hearing level after microdrill is similar to diode laser, but microdrill has shorter surgical time.
目的： 比较耳内镜下人工镫骨植入手术中微钻与激光打孔的效果。 方法： 回顾性纳入复旦大学附属眼耳鼻喉科医院2020年1月至2023年12月确诊并接受耳内镜下镫骨植入的耳硬化症患者，根据打孔方式分为微钻打孔组和激光打孔组。比较两组患者手术时间、术后听力水平和不良反应发生情况。 结果： 共纳入148例患者，男41例，女107例，年龄（42.8±7.7）岁；其中微钻打孔组81例，激光打孔组67例。两组患者年龄、性别、病程、患耳侧别比较差异均无统计学意义（均P>0.05）。微钻打孔组和激光打孔组术前气骨导差（ABG）分别为（27.0±5.5）分贝听力水平（dB HL）和（25.0±5.1）dB HL，差异无统计学意义（P=0.191）；术后ABG分别为（14.0±2.6）dB HL和（12.1±2.7）dB HL，差异亦无统计学意义（P=0.595）；与术前比较，两组患者术后ABG均缩小（均P<0.05）。微钻打孔组患者术后眩晕7例（8.6%），激光打孔组6例（9.0%），差异无统计学意义（P=0.947）。与激光打孔组比较，微钻打孔组手术时间更短［（53.0±9.0）min比（59.3±12.8）min，P<0.001］。 结论： 耳内镜下人工镫骨植入手术中微钻与激光打孔效果相似，微钻打孔手术时间相对较短。.