TITLE:
Microdrill, Diode Laser, and Manual Microsurgical Stapedoplasty: A Comparative Study
AUTHORS:
Priit Kasenõmm, Maris Suurna
KEYWORDS:
Otosclerosis; Stapes Surgery; Diode Laser; Operation Time
JOURNAL NAME:
International Journal of Otolaryngology and Head & Neck Surgery,
Vol.3 No.1,
January
9,
2014
ABSTRACT:
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.