Is one of these two techniques: CO2 laser versus microdrill assisted stapedotomy results in better post-operative hearing outcome?

Al-Tamami, Nasser; Etages, Gunther Huyghues des; Fieux, M.; Coudert, Aurélie; Hermann, R.; Zaouche, S.; Truy, Éric; Tringali, S.

doi:10.1007/s00405-019-05415-7

Cited by 11 publications

(12 citation statements)

References 25 publications

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“…Stimulation of the cochlea with a traditional piston prosthesis is not perfect. [8][9][10] The main disadvantage of such a prosthesis is the generation of too weak pressure wave in the perilymph. This is due to the approximately 16 times smaller surface area of the vibrating piston (*0.2-0.3 mm 2 , ø: 0.4/0.6 mm) compared to the surface area of the stapes plate (*3.2 mm 2 ).…”

Section: Discussionmentioning

confidence: 99%

Hearing Improvement in the Patients Operated on Otosclerosis by Right-Handed Surgeons

2020

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Background: Otosclerosis is a disease of the osseous labyrinth. The disease causes 5% to 9% of all cases of hearing loss and 18% to 22% of conductive hearing loss. The treatment of choice is a surgery. The hearing improvement after the operation is determined by various factors. Aims/Objectives: The aim of the analysis is to determinate changes in hearing after stapedoplasty in view of surgery side in the patients operated on otosclerosis by right-handed surgeons. Material and Methods: The analysis involved patients hospitalized and operated on otosclerosis between 2012 and 2018. Only patients with their first middle ear surgery due to otosclerosis were included in the study. The patients were operated by 2 right-handed surgeons who used the same surgical technique and had similar experience in otosclerosis surgery. The study included patients who were divided into 2 groups: with self-tightening prosthesis and with manually tightening prosthesis. Results: The procedure performed by right-handed operators on the left side using prostheses requiring manual fixation on the incus was associated with poorer audiometric results compared to the results of surgeries on the right side. In patients with the self-tightening prostheses, the audiometric improvement of hearing was bilaterally comparable independently from operation side. Conclusion: (1) The dependence of hearing improvement on the surgery side was demonstrated in cases of surgeries performed on the left ear by right-handed surgeons, particularly with manually tightening prosthesis. (2) Self-tightening prostheses in stapedotomy limit the human factor, reducing the risk of complications after otosclerosis surgery and provide repeatable hearing improvement.

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Section: Discussionmentioning

confidence: 99%

Hearing Improvement in the Patients Operated on Otosclerosis by Right-Handed Surgeons

2020

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“…High-frequency BC-PTA (HFBC) was assessed by averaging the BC threshold for frequencies 1, 2, and 4 kHz [ 11 ]. The preoperative to postoperative change in this value is a measure of SNHL.…”

Section: Methodsmentioning

confidence: 99%

“…The preoperative to postoperative change in this value is a measure of SNHL. Positive values reflect improved BC levels (also referred to as overclosure), while negative values indicate high-frequency SNHL [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

“Hot” vs “Cold” endoscopic stapes surgery: a matched case–control study

Molinari

Fernandez

Melchiorri

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose To compare hearing results and complication rates between two groups of patients operated on by endoscopic stapes surgery (ESS) for otosclerosis, either with CO2 fiber laser or microdrill. Methods A case–control study was performed. All consecutive cases of CO2 fiber laser ESS operated at a single center during the period 2017–2020 (case group) were matched to a control group of patients operated by traditional technique, according to year of surgery, preoperative mean air–bone gap, sex and age. Audiological data from preoperative and postoperative examinations and complication rates were compared. Results 46 cases were included. Mean operative time was significantly longer in the laser cohort (65 min) than in the drill one (45 min) (p = 0.003). Similar results were found in the two groups regarding the mean postoperative BC-PTA. The high-frequency bone conduction resulted significantly higher in the laser group (p = 0.002), suggesting an overclosure effect in the laser group. Consistently, a significant improvement of the BC-PTA threshold at 2000 Hz postoperatively was found in the laser group (p = 0.034). The postoperative AC-PTA significantly improved in both groups at all frequencies (p < 0.05), except for the AC threshold at 8 kHz. Similar rates of complications were found in the two groups. Conclusion This study is the first to compare hearing results and complications between CO2 fiber laser and microdrill in ESS. Our results demonstrated similar functional outcomes between the two groups, confirming ESS as safe and effective, regardless of the technique used.

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“…(10) La primera cirugía para la otosclerosis fue realizada por Shea en 1956 quien consideró la realización del retiro de la platina del estribo o estapedectomia, sin embargo en el tiempo se fue considerando la realización de una fenestra o perforación parcial de la platina del estribo hacia el año 1963 por Marquet quien se considera el pionero de ésta técnica (11,12). La fenestra se puede realizar con microfresas o laser, al momento de evaluar los resultados audiológicos se evidencia mínima superioridad en el cierre del gap aéreo óseo ≤10db con el uso del laser 84% vs microfresas con un 80%, siendo comparables los resultados (13,14).…”

Section: Discusión Diagnóstico Y Tratamiento Quirúrgicounclassified

Caracterización de pacientes con otosclerosis con estapedotomía a través de abordaje transcanal y retroauricular en un hospital universitario

Becerra-CuervoO¹,

Caraballo²

2022

Acta otorrinolaringol cir cabeza cuello

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Introducción: La otosclerosis manejada quirúrgicamente con estapedotomia ha mostrado mejora del umbral auditivo mediante un abordaje trascanal o retroauricular. Objetivo: Caracterizar la respuesta al tratamiento quirúrgico con estapedotomia trascanal y retroauricular en pacientes con diagnóstico de otosclerosis en un centro universitario. Diseño: Estudio observacional descriptivo retrospectivo tipo serie de casos. Metodología: Se incluyeron pacientes con diagnósticos de otosclerosis atendidos en el Hospital Universitario Clínica San Rafael quienes cumplieron criterios de elegibilidad entre el año 2014 a 2020. Resultados: Se incluyeron 33 pacientes intervenidos con abordaje trascanal y 8 con abordaje retroauricular, la edad promedio fue de 46.6 años. La mayoría pacientes de sexo femenino (56.1%). Se evidenció mejora del umbral auditivo en el 89.9% del total de la muestra. La presencia de variantes anatómicas se describió en un 26.8%, la variante más común fue el prolapso del nervio cuerda del tímpano (14.5%). La complicación intraoperatoria más común fue la sección del nervio cuerda del tímpano (9.8%). La presencia de complicaciones y variantes anatómicas fue más prevalente con abordaje retroauricular. Conclusiones: La estapedotomia con abordaje retroauricular y trascanal mostro mejora del umbral auditivo equiparable a la literatura mundial, la presencia de variantes anatómicas se correlaciono con complicaciones postoperatorias.

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Is one of these two techniques: CO2 laser versus microdrill assisted stapedotomy results in better post-operative hearing outcome?

Cited by 11 publications

References 25 publications

Hearing Improvement in the Patients Operated on Otosclerosis by Right-Handed Surgeons

Hearing Improvement in the Patients Operated on Otosclerosis by Right-Handed Surgeons

“Hot” vs “Cold” endoscopic stapes surgery: a matched case–control study

Caracterización de pacientes con otosclerosis con estapedotomía a través de abordaje transcanal y retroauricular en un hospital universitario

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