A comparison of the hearing results of KTP and Erbium YAG laser stapedotomy

Timoshenko, Andrei P.; Oletski, A.; Prades, Jean-Michel; Asanau, A.; Bertholon, P.; Martin, C. J.

doi:10.1080/00016480802179727

Cited by 9 publications

(3 citation statements)

References 10 publications

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“…Adequate randomization, treatment allocation, and blinding were either not achieved or no information was provided regarding these criteria. Standardization of treatment was unclear in 3 of the included studies (13,16,17). Laser settings were not adequately described in these studies.…”

Section: Retrieving Studiesmentioning

confidence: 99%

Outcomes of Different Laser Types in Laser-assisted Stapedotomy

Kamalski¹,

Wegner²,

Tange³

et al. 2014

Otology &Amp; Neurotology

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A total of 383 unique articles were retrieved. Four studies provided direct evidence, whereas all studies carried moderate to high risk of bias. After exclusion of the studies that did not provide direct evidence and/or carried high risk of bias, 2 studies were considered eligible for data extraction. This best available evidence shows a slightly better air-bone gap closure for CO2 laser compared to potassium titanyl phosphate laser, but the clinical relevance is unclear. The risk difference of 28.1% [95% confidence interval, 22.8, 33.4] between CO2 and erbium yttrium aluminium garnet favors CO2 laser. Unfortunately, this current best available evidence is insufficient to draw any definitive conclusions on which laser to use for fenestration in stapedotomy.

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Section: Retrieving Studiesmentioning

confidence: 99%

Outcomes of Different Laser Types in Laser-assisted Stapedotomy

Kamalski¹,

Wegner²,

Tange³

et al. 2014

Otology &Amp; Neurotology

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“…Diese können vorübergehend sein oder persistieren. Andere Autoren befanden den Er:YAG-Laser jedoch als sicher [38,50].…”

Section: Diskussionunclassified

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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“…Due to a low absorption of energy in water both the argon and KTP laser have a high penetration depth within the perilymph and subsequently a theoretical risk of inner ear damage by a direct impact of laser energy ( 14 , 15 ). However, in the past several studies have demonstrated good postoperative results with no significant inner ear damage ( 16 – 18 ). Hence both, the argon and the KTP laser are widely used lasers for stapedotomy.…”

mentioning

confidence: 99%

Picosecond Infrared Laser (PIRL) Application in Stapes Surgery—First Experience in Human Temporal Bones

Petersen

Gliese

Maier

et al. 2018

Otology &Amp; Neurotology

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Objective:Using a contact-free laser technique for stapedotomy reduces the risk of mechanical damage of the stapes footplate. However, the risk of inner ear dysfunction due to thermal, acoustic, or direct damage has still not been solved. The objective of this study was to describe the first experiences in footplate perforation in cadaver tissue performed by the novel Picosecond-Infrared-Laser (PIRL), allowing a tissue preserving ablation.Patients and Intervention:Three human cadaver stapes were perforated using a fiber-coupled PIRL. The results were compared with footplate perforations performed with clinically applied Er:YAG laser. Therefore, two different laser energies for the Er:YAG laser (30 and 60 mJ) were used for footplate perforation of three human cadaver stapes each.Main Outcome Measure:Comparisons were made using histology and environmental scanning electron microscopy (ESEM) analysis.Results:The perforations performed by the PIRL (total energy: 640–1070 mJ) revealed a precise cutting edge with an intact trabecular bone structure and no considerable signs of coagulation. Using the Er:YAG-Laser with a pulse energy of 30 mJ (total energy: 450–600 mJ), a perforation only in the center of the ablation zone was possible, whereas with a pulse energy of 60 mJ (total energy: of 195–260 mJ) the whole ablation zone was perforated. For both energies, the cutting edge appeared irregular with trabecular structure of the bone only be conjecturable and signs of superficial carbonization.Conclusion:The microscopic results following stapes footplate perforation suggest a superiority of the PIRL in comparison to the Er:YAG laser regarding the precision and tissue preserving ablation.

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A comparison of the hearing results of KTP and Erbium YAG laser stapedotomy

Abstract: The study indicated that KTP and Er: YAG stapedotomies have similar rates of the air-bone gap closure. There was no significant postoperative sensorineural hearing loss found in both techniques.

Cited by 9 publications

References 10 publications

Outcomes of Different Laser Types in Laser-assisted Stapedotomy

Outcomes of Different Laser Types in Laser-assisted Stapedotomy

Laserstapedotomie

Picosecond Infrared Laser (PIRL) Application in Stapes Surgery—First Experience in Human Temporal Bones

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