Small fenestra stapedotomies with and without ktp laser: A comparison

Silverstein, Herbert; Rosenberg, Seth I.; Jones, Raleigh O.

doi:10.1288/00005537-198905000-00003

Cited by 91 publications

(71 citation statements)

References 6 publications

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“…Silverstein et al [20] reported a higher incidence of postoperative vertigo in the laser stapedotomy group compared to the conventional group (39% vs. 12%, respectively). However, in another study, there was no difference between these groups in video-oculographic findings at postoperative week 1 [9] .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Videonystagmography and Audiological Findings after Stapedotomy; CO2 Laser vs Perforator

Karaca

Basut²,

Demir³

et al. 2016

Int Adv Otol

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OBJECTIVE:Various types of laser, microdrill, and perforator are effectively used in the surgical treatment of otosclerosis. However, they have certain disadvantages along with advantages. The aim of this study was to evaluate the effects of carbon dioxide (CO 2 ) laser and perforator stapedotomy techniques on audiological outcomes and postoperative vestibular functions via videonystagmography (VNG). MATERIALS and METHODS:This prospective and randomized clinical study was conducted in an academic tertiary medical center. Sixty-nine patients diagnosed with otosclerosis who underwent stapedotomy were enrolled in this study. Patients were divided into two groups based on the technique used in stapedotomy: CO 2 laser and perforator. Postoperative hearing gain and VNG findings were the main outcome measures. Subsequently, the two study groups were compared for analysis. RESULTS:The preoperative air-bone gap was 32.7±8.9 decibel (dB) in the study population and it was improved to 12.9±8.4 dB after operation. There were no differences in VNG findings and vertigo symptoms between the laser and perforator groups at postoperative day 2. There was no significant gain difference regarding the air conduction, bone conduction, and air-bone gap between the two groups (p=0.294, p=0.57, and p=0.37, respectively). CONCLUSION:Both CO 2 laser and perforator stapedotomy have successful audiological outcomes with no difference in postoperative vestibular disturbance.

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Section: Discussionmentioning

confidence: 99%

Comparison of Videonystagmography and Audiological Findings after Stapedotomy; CO2 Laser vs Perforator

Karaca

Basut²,

Demir³

et al. 2016

Int Adv Otol

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“…In stapedotomy, the blood is located in the vestibule, possibly causing vertigo. Several authors report (transient) vertigo following KTP or argon laser stapedotomy in patients, ranging from 6.6 to 39% [1,4,5,6]. As blood in the vestibule could be absorbed in time, clinical symptoms of vertigo subside.…”

Section: Discussionmentioning

confidence: 99%

“…The transmission of the laser light through the perilymph may result in the absorption of residual energy in the neuroendothelium in the vestibule. Authors have suggested that this could explain the (temporary) vertigo complaints in patients after KTP laser-assisted stapedotomy [1,4,5,6]. …”

Section: Introductionmentioning

confidence: 99%

Effect of KTP Laser Cochleostomy on Morphology in the Guinea Pig Inner Ear

Kamalski¹,

Peters²,

Boorder³

et al. 2014

ORL

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Background: The main advantage of using the KTP (potassium-titanyl-phosphate) laser for stapedotomy instead of the conventional micropick instrument is the smaller risk for mechanical damage. However, the KTP laser could theoretically inflict damage to inner ear structures. We hypothesize that KTP laser light [wavelength (λ) = 532 nm] is hardly absorbed in perilymph but well absorbed in solid structures. The aim of this pilot study was to assess if damage occurred after KTP laser cochleostomy in an animal model and, if so, to what extent and at which settings. Materials and Methods: In six guinea pigs, a KTP laser cochleostomy at the basal turn was created. Laser settings of 1, 3 and 5 W and 100 ms pulse time (n = 2 each) were used. Histological preparations were studied for damage to neuroendothelial cells and intrascalar blood. Results: No damage to inner ear neuroendothelial cells was observed, even at the highest power. Blood clots in the scala tympani from vessels in the cochlear wall were seen. The effects were minimal in the lowest, currently clinically used settings. Conclusion: KTP laser cochleostomy gives no damage to inner ear neuroendothelial cells but may cause intrascalar hemorrhages.

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“…Nessas revisões não usamos o laser [12][13][14][15][16] e mantivemos a técnica tradicional da cirurgia 1,2,[17][18][19][20] , com o emprego de ganchos especializados, usando raramente brocas afiadas para a abertura da base do estribo. A prótese empregada nas revisões foi na grande maioria a de teflon de 0,6mm ou 0,4mm de espessura e também em alguns casos a prótese de aço e teflon.…”

Section: Introductionunclassified

Cirurgia revisional de 74 casos de estapedectomia/estapedotomia

Mello

Azevedo

2003

Rev. Bras. Otorrinolaringol.

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OBJETIVO: O objetivo deste estudo é o de identificar as diversas causas que nos obrigam a novo procedimento cirúrgico. Apesar de várias alterações técnicas como platinectomia total, platinectomia parcial, interposição óssea, fenestra na platina e o emprego de vários tipos de próteses, os problemas continuam a existir, talvez também pelo pouco treinamento feito pelos residentes nos Centros Universitários, onde o número de cirurgias estapedianas vem caindo ano a ano, o que leva à pouca experiência destes residentes em sua vida futura. FORMA DE ESTUDO: Avaliação Retrospectiva. MATERIAL E MÉTODO: Baseou-se em 74 casos de revisões de estapedectomia, realizadas em 68 pacientes, sendo 47 ouvidos submetidos à primeira revisão e 4 ouvidos submetidos à uma segunda revisão, todos operados anteriormente pelo autor, de uma população de 725 estapedectomias realizadas na clínica privada e 282 estapedectomias realizadas no Hospital Universitário Antônio Pedro (HUAP) - Universidade Federal Fluminense/Niterói-RJ, de julho de 1980 a junho de 1999. Acrescentamos mais 21 casos operados de primeira revisão e de 2 casos operados de segunda revisão oriundos de outros serviços. RESULTADOS: Considerando todos os casos de revisões cirúrgicas realizadas, os ganhos auditivos obtidos foram os seguintes: em 78,3% dos pacientes os ganhos auditivos alcançados foram de até 20dB; em 10,8% dos pacientes de 20dB a 25dB; em 8,2% dos pacientes acima de 25dB, tendo ocorrido anacusia em 2,7% dos pacientes. A avaliação auditiva incluiu o limiar aéreo-ósseo de 250 a 8000Hz com a discriminação vocal e o SRT, sendo que nas freqüências de 500, 1000 e 2000Hz os limiares das vias aérea e óssea foram calculados através dos audiogramas realizados nos pré e pós-operatórios. Os resultados auditivos pós-operatórios dependem da afecção cirúrgica encontrada, principalmente pela presença ou ausência da bigorna e pela reobliteração óssea na janela do vestíbulo. Fizemos o acompanhamento audiológico de todos os ouvidos operados após seis meses da cirurgia e de sessenta e seis ouvidos operados com um ano de cirurgia e com oito pacientes não retornando ao segundo exame.

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Small fenestra stapedotomies with and without ktp laser: A comparison

Cited by 91 publications

References 6 publications

Comparison of Videonystagmography and Audiological Findings after Stapedotomy; CO2 Laser vs Perforator

Comparison of Videonystagmography and Audiological Findings after Stapedotomy; CO2 Laser vs Perforator

Effect of KTP Laser Cochleostomy on Morphology in the Guinea Pig Inner Ear

Cirurgia revisional de 74 casos de estapedectomia/estapedotomia

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