Microdrill, CO2-Laser, and Piezoelectric Stapedotomy

Cuda, Domenico; Murri, Alessandra; Mochi, Paolo; Solenghi, Tommaso; Tinelli, Nicoletta

doi:10.1097/mao.0b013e3181b76b08

Cited by 38 publications

(35 citation statements)

References 10 publications

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“…The long-term follow-up (on average 45 months) confirmed the stability of the hearing improvement. In the postoperative assessment, average values of ACPTA for 0.25 and 0.5 kHz are substantially lower compared to those at 2 and 4 kHz, which results in higher ABG closure at lower frequencies, as already reported in analogous studies [2]. Less residual ABG at low frequencies represents unanimously a successful marker for functional outcome.…”

Section: Discussionmentioning

confidence: 60%

“…Several laser systems have been employed for stapes surgery in order to obtain higher functional results compared to common traditional devices such as manual perforator and/or ultralight microdrill [2,3]. Over the years, standardized and reproducible outcomes have been achieved, together with progressive reduction of the rates of intraoperative labyrinthine trauma, due to footplate manipulation.…”

Section: Introductionmentioning

confidence: 99%

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Long-term follow-up after “one-shot” CO2 laser stapedotomy: is the functional outcome stable during the years?

Sergi

Lucidi

Corso

et al. 2016

Eur Arch Otorhinolaryngol

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The use of "one-shot" CO laser technique for a primary small-fenestra stapedotomy is well established, but few papers report the long-term functional results. We retrospectively reviewed medical records of 198 patients, treated for otosclerosis from January 2008 to December 2011, at the Department of Head and Neck Surgery, Catholic University of Rome. Statistical comparison between audiological thresholds obtained 24 h preoperatively, at early (4 weeks) and late postoperative examinations (mean time 45 months), was performed. Comparison of preoperative vs both early and late postoperative ACPTA showed a statistically significant difference (respectively 55 vs 33 and 31 dB; p < 0.001). No statistical difference was observed between preoperative, early and late postoperative BCPTA (respectively 23 vs 23 and 22 dB; p > 0.05). Both early and late postoperative ABG improved significantly compared to the preoperative one (respectively 10 and 9 vs 32 dB; p < 0.001). No statistical difference was found in comparison of early vs late postoperative ACPTA (respectively 33 vs 31 dB; p > 0.05), early vs late postoperative ABG (respectively 10 vs 9 dB; p > 0.05) and early vs late ABG gain (respectively 22 vs 23 dB; p > 0.05). No subjects developed postoperative complications requiring revision surgery or late deterioration of hearing threshold. The analysis of our data suggests that "one-shot" CO laser stapedotomy is an effective and safe procedure: it allows a rapid stapedotomy without damages for the inner ear and optimal functional results that remain stable during the years.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Long-term follow-up after “one-shot” CO2 laser stapedotomy: is the functional outcome stable during the years?

Sergi

Lucidi

Corso

et al. 2016

Eur Arch Otorhinolaryngol

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“…In average, the operation time reduced about onethird and the completion rate of stapes surgery increased about one-fifth after implementing diode laser in our department. Several studies have also demonstrated that regardless of devices used to create the stapedotomy (manual perforator, micro-drill or lasers) no significant difference in either post-operative ABG closure or postoperative sensorineural hearing loss can be found [4][5][6][7][8][9][10]. Some studies have shown that micro-drill is superior to manual perforator [14] and CO2-laser is superior to potassium-titanyl-phosphate (KTP) laser [15], but these improvements were not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…One of the most remarkable technical innovations was the introduction of lasers in stapes surgery already three decades ago [2,3]. However, several earlier and latter studies have shown no significant differences between laser-assisted, micro-drill and manual microsurgical stapedoplasty with regard to hearing outcome [4][5][6][7][8][9][10]. Instead of better hearing outcome, the micro-drill and/or laser appears to be very helpful to provide greater accuracy during precise manipulations and thereby reduce surgical trauma, which is important advantages regarding patients' safety compared to handheld instruments [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Microdrill, Diode Laser, and Manual Microsurgical Stapedoplasty: A Comparative Study

Kasenõmm¹,

Suurna²

2014

IJOHNS

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Background: To evaluate hearing outcome, operation time and post-operative hospital stay after primary stapedoplasty with three different techniques: manual microsurgical, microdrill-assisted, and microdrill-and laser-assisted technique. Methods: A retrospective analysis of 150 consecutive cases of primary otosclerosis was operated by one surgeon. The patients were divided into three groups depending on the utilized surgical techniques: a fully manual microsurgical stapedoplasty (n = 56), microdrill-assisted stapedoplasty (n = 32), and microdrill-and laser-assisted stapedoplasty (n = 62). The mean pre-and post-operative air-bone gap was calculated by using pre-and post-operative mean pure tone air-and bone-conduction thresholds at 500, 1000, 2000 and 4000 Hz. Results: There were no statistically significant differences in the hearing outcome between the groups. The closure of air-bone gap and the improvement of the hearing were demonstrated in all study groups. Introduction of diode laser for stapes surgery resulted in significantly reduced operation time (about one-third) and the increase in the completion of surgery from 81.5% to 96.7%. At the same time, the rate of complications stayed low and hospital stay dropped from three days to one day. There were no major post-operative complications in any study groups. Conclusions: Application of diode laser in stapes surgery significantly reduced operation time and increased completion rate of surgery. No statistically significant difference was found between three surgical techniques regarding hearing outcome.

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“…Der Vergleich von Hörergebnissen nach Anwendung des Er:YAG-, KTP-und CO 2 -Lasers zeigte die größte Schallleitungsverbesserung nach CO 2 -Laser-Stapedotomien [33,53]. Auch der Vergleich des CO 2 -Lasers mit konventionellen Methoden der Stapedotomie (Mikrobohrer, Piezoelektrik) verlief zugunsten des CO 2 -Lasers [8]. Der Vergleich zwischen dem Argon-und dem CO 2 -Laser ergab keinen signifikanten Unterschied [6].…”

Section: Literaturvergleich Der Ergebnisse Nach Stapedotomieunclassified

Laserstapedotomie

Albers

Wagner

Stölzel

et al. 2011

HNO

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In addition to hearing aids, stapesplasty represents the standard treatment of otosclerosis-induced hearing loss. In this procedure, the stapes superstructure is replaced by a prosthesis that is attached to the long process of the incus and communicates through a perforation in the footplate with the perilymphatic space of the inner ear. The removal of the stapes superstructure and perforation of the footplate are the critical steps of this surgical procedure. With the introduction of laser-assisted perforation techniques, the surgical safety of this method has been improved compared to conventional techniques. KTP, argon, as well as diode, Er:YAG and CO(2) lasers are used for stapedotomy. By using the CO(2) laser in conjunction with a scanner system, the number of laser applications required for the perforation of the footplate has been markedly reduced. In contrast to other systems, a more reproducible perforation diameter of the stapes footplate is achieved with a CO(2) laser equipped with a scanner. Complications such as uncontrolled leakage of perilymph, irradiation of inner ear structures or the occurrence of pressure waves with subsequent damage to the inner ear can be reduced by using a CO(2) laser. In this review, the surgical technique of CO(2) laser stapedotomy, including clinically established variants and paying particular attention to the one-shot technique, are described and discussed in comparison to other laser systems.

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Microdrill, CO2-Laser, and Piezoelectric Stapedotomy

Cited by 38 publications

References 10 publications

Long-term follow-up after “one-shot” CO2 laser stapedotomy: is the functional outcome stable during the years?

Long-term follow-up after “one-shot” CO2 laser stapedotomy: is the functional outcome stable during the years?

Microdrill, Diode Laser, and Manual Microsurgical Stapedoplasty: A Comparative Study

Laserstapedotomie

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