Background and Objectives Laser‐assisted stapedotomy has become a well‐established alternative to the mechanical drilling method. The goal of this study is to quantify the mechanical and thermal tissue effects and to determine optimum erbium laser parameters for safe clinical treatment. Study Design/Materials and Methods On an inner ear model, time‐resolved pressure measurements and Schlieren optical flash photography were performed during the perforation of the stapes foot plate using an erbium laser at 2.79 μm. The laser radiation was transmitted via an optical zirconium fluoride fiber. The laser‐treated foot plates were investigated by light microscopy and scanning electron microscopy to visualize the laser‐induced tissue effects. Results Perforation of the stapes foot plate can be performed with a few erbium laser pulses with high precision and a thermal damage zone of <10 μm. Strong pressure transients were found to be generated by the bone ablation process and the collapse of a vapor channel created in the perilymph after fenestration. Conclusion From the comparison of the laser‐induced pressure with the limit graph to avoid hearing defects published by Pfander, an unobjectionable use of the erbium laser is deduced for fluences <10 J cm2. The erbium laser seems to represent an ideal instrument for middle ear surgery with all the advantages (precision, fiber optic transportable, high ablation efficiency, safety) desired for clinical application. © 1996 Wiley‐Liss, Inc.

Lugol chromoendoscopy enhances the detection rate of high-risk lesions with dysplasia or carcinoma in situ in large unstained lesions. Biomarkers such as aneuploidy and p53 LOH from brush cytology were not of additional benefit in this setting.

Antibiotic-containing nasal packing effectively inhibits potentially infectious germs (including S. aureus) in the nasal flora and secondarily may diminish the incidence of postoperative infections.

Cholesterol granulomata of the middle ear occasionally accompany chronic middle-ear diseases with diminished ventilation. In the paranasal sinuses, especially in the frontal sinus, they have occasionally been mentioned in the literature.Disordered ventilation and impaired drainage are decisive pathogenic factors in the causation of cholesterol granuloma. Views remain divided on the source of the cholesterol and on the importance of bleeding in the development of cholesterol granuloma. Two patients with a cholesterol granuloma of the frontal sinus are presented and discussed.

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