Comparison Between 2 Laser Systems, Er-Yag and CO2, in Stapes Surgery

Szyfter, Witold; Mielcarek-Kuchta, Daniela; Miętkiewska-Leszniewska, Dorota; Młodkowska, Anna; Laczkowska-Przybylska, J

doi:10.1097/mao.0b013e31827853c3

Cited by 11 publications

(11 citation statements)

References 16 publications

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“…In 1999, Hausler first reported the application of an erbium-doped yttrium aluminum garnet (Er:YAG) laser system in stapedotomy and obtained positive results, with an air-bone gap (ABG) of less than 20 dB in 15 cases (ears) [10] ; similar findings were first reported in China in 2004. The usefulness of both CO 2 and Er:YAG lasers in stapes surgery have been confirmed with a decrease in the hearing threshold [11] . The 3-year follow-up of patients who received laser treatment showed that the Er:YAG laser was the safest type of pulsation laser for use in ear surgery because no facial nerve paralysis or adverse effects were observed in the inner ear function [12] .…”

Section: Introductionmentioning

confidence: 82%

Comparative Analysis of Laser and Non-Laser Stapes Surgeries

Gao²,

Tang³

et al. 2017

Int Adv Otol

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OBJECTIVE:This study aimed to observe differences in the efficacy of laser and surgical treatments of middle-ear conductive hearing loss (MECHL). MATERIALS and METHODS:A total of 276 ears of 267 patients with MECHL were divided into laser (n=172) and surgical (n=104) treatment groups according to the treatment method. Changes in the air-bone gap (ABG) after treatment and at the time of final follow-up were compared. An ABG value <20 dB was defined as effective and an ABG value <10 dB, significantly effective. The long-term treatment effects were also compared at the time of final follow-up. Additionally, postoperative adverse reactions were recorded for both the groups. RESULTS:The mean follow-up period was 76.77±43.62 months (range: 12-168 months). No significant difference in ABG was found between the two groups (21.31±11.64 dB vs. 19.14±9.79 dB, p>0.05). However, the laser treatment group showed slightly better results than the surgical treatment group at the final follow-up, although the difference between the groups was not found to be significant (11.69±9.98 dB vs. 12.62±10.94 dB, p>0.05). There was no difference in the long-term treatment effects between the two groups (effective: 87.21% vs. 88.46%, p>0.05; significantly effective: 55.81% vs. 56.73%, p>0.05). The incidence rates of postoperative adverse reactions were not significantly different. CONCLUSION:The treatment efficacy of laser and surgical treatments for MECHL are similar.

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Section: Introductionmentioning

confidence: 82%

Comparative Analysis of Laser and Non-Laser Stapes Surgeries

Gao²,

Tang³

et al. 2017

Int Adv Otol

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“…The ABG closure was calculated using the four-tone average for pre- and post-operative air conduction and bone conduction thresholds in 86.3 per cent of the papers; 4 , 6 , 7 , 14 – 21 , 23 – 53 , 55 , 59 , 62 however, 3 kHz was only used in 45.1 per cent of these calculations 6 , 7 , 15 , 16 , 20 , 21 , 24 , 28 , 32 – 34 , 38 , 40 – 44 , 47 , 51 , 53 , 55 , 57 , 59 . The remaining papers either substituted 3 kHz with 4 kHz (in 79.2 of papers), or averaged 2 kHz and 4 kHz (in 16.7 per cent).…”

Section: Discussionmentioning

confidence: 99%

Reporting in stapes surgery: are we following the guidelines?

Watson

Cruz

2018

J. Laryngol. Otol.

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“…The pulse energy for Er:YAG laser used for stapedotomy ranges from 10 to 450 mJ in the literature ( 20 , 29 ). The upper limit of pulse energy differs between authors.…”

Section: Discussionmentioning

confidence: 99%

“…Tissue with high water content can be ablated precisely with no or minimal thermal effect to the inner ear ( 10 ). Several clinical studies have demonstrated the feasibility and efficiency of the Er:YAG laser in stapes surgery ( 20 ). However, at the same time, the Er:YAG laser produces acoustic shock waves causing explosive ablation of bone and generates a shockwave through the inner ear, which can potentially harm inner ear function ( 10 , 21 ).…”

mentioning

confidence: 99%

Picosecond Infrared Laser (PIRL) Application in Stapes Surgery—First Experience in Human Temporal Bones

Petersen

Gliese

Maier

et al. 2018

Otology &Amp; Neurotology

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Objective:Using a contact-free laser technique for stapedotomy reduces the risk of mechanical damage of the stapes footplate. However, the risk of inner ear dysfunction due to thermal, acoustic, or direct damage has still not been solved. The objective of this study was to describe the first experiences in footplate perforation in cadaver tissue performed by the novel Picosecond-Infrared-Laser (PIRL), allowing a tissue preserving ablation.Patients and Intervention:Three human cadaver stapes were perforated using a fiber-coupled PIRL. The results were compared with footplate perforations performed with clinically applied Er:YAG laser. Therefore, two different laser energies for the Er:YAG laser (30 and 60 mJ) were used for footplate perforation of three human cadaver stapes each.Main Outcome Measure:Comparisons were made using histology and environmental scanning electron microscopy (ESEM) analysis.Results:The perforations performed by the PIRL (total energy: 640–1070 mJ) revealed a precise cutting edge with an intact trabecular bone structure and no considerable signs of coagulation. Using the Er:YAG-Laser with a pulse energy of 30 mJ (total energy: 450–600 mJ), a perforation only in the center of the ablation zone was possible, whereas with a pulse energy of 60 mJ (total energy: of 195–260 mJ) the whole ablation zone was perforated. For both energies, the cutting edge appeared irregular with trabecular structure of the bone only be conjecturable and signs of superficial carbonization.Conclusion:The microscopic results following stapes footplate perforation suggest a superiority of the PIRL in comparison to the Er:YAG laser regarding the precision and tissue preserving ablation.

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Comparison Between 2 Laser Systems, Er-Yag and CO2, in Stapes Surgery

Abstract: To sum up, our observations have proven the usefulness of 2 laser systems: CO2 and Er-Yag lasers in stapes surgery. In both groups, a decrease in the hearing threshold was obtained.

Cited by 11 publications

References 16 publications

Comparative Analysis of Laser and Non-Laser Stapes Surgeries

Comparative Analysis of Laser and Non-Laser Stapes Surgeries

Reporting in stapes surgery: are we following the guidelines?

Picosecond Infrared Laser (PIRL) Application in Stapes Surgery—First Experience in Human Temporal Bones

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