Stapedotomy with Microdrill or Carbon Dioxide Laser: Influence on Inner Ear Function

Abstract

Our results confirm the transient depression of inner ear function in the immediate postoperative period, with recovery within the first weeks after surgery. In the studied population, no statistically significant difference was found between the two techniques that were used to make the calibrated hole (laser versus microdrill). These results demonstrate that both techniques possess the same early effect regarding inner ear function. The authors hypothesize that an early inflammatory reaction could be the cause of the transient bone conduction shift.

Microdrill, CO2-Laser, and Piezoelectric Stapedotomy

“…This time was chosen as a good compromise between the long-term results with the inherent risk to lose people at follow-up and the early fluctuation in sensorineural function. As some studies demonstrate (12,17) the main BC threshold variations occur in the first 2 weeks after the operation. Therefore, the comparison performed 1 month after the operation should be considered reliable.…”

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

“…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.…”

“…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].…”

Experimental study on thermic effects, morphology and function of guinea pig cochlea: A comparison between the erbium:yttrium–aluminum–garnet laser and carbon dioxide laser

“…Opening of the inner ear in stapedotomy can be performed with handheld perforators, or, in cases of thickened otosclerotic plate, with a microdrill. Alternatively, the application of different lasers has been described in experimental and clinical studies recently [4][5][6][7][8][9][10].…”

“…The application of all of these laser systems for stapedotomy has been reported by different authors [1,2,[4][5][6][7][8][9][10].The CO 2 laser is well absorbed in water with a wavelength of 10.6 mm. It can be applied in either a continuous or a pulsed mode.…”