Stapedectomy vs Stapedotomy: Do You Really Need a Laser?

Laser stapedotomy

“…Contrary to our observations, Sedwick et al (1997) reported that there was no significant difference in neither the post-operative air-bone gap nor the postoperative sensorineural hearing loss. Time did not allow for estimation of the occurrence of late complications that may be seen in all techniques of surgery for otosclerosis as reported by Pedersen (1996).…”

Comparative study showing relevance of prosthesis diameter and hearing outcome in stapes surgery

“…Most of the patients were in the age group of 40-60 years. 10,11 This was in accordance with that reported earlier.…”

How we do it: Switching from mechanical perforation to the CO2 laser; audit results of primary small‐fenestra stapedotomy in a district general hospital

“…Many authors have reported that the laser is superior to the mechanical technique with regards to Air–Bone Gap closure 1,2,4–7 . We did not, however, find a significant difference between the two, which is compatible with other reports 3,8,10 . Concerns were expressed about the potential risk of heating the perilymph with the CO 2 laser, 11 but experimental studies showed that 90% of the energy of the CO 2 laser is absorbed by the labyrinthine fluid and is unlikely to be transmitted to the pigmented cells of the inner ear 12 .…”