Advantages of CO2 laser use in surgical management of otosclerosis

Abstract

On the basis of the degree of postoperative hearing improvement, tinnitus and the incidence of complications it can be concluded that the use of CO2 laser during inverse stapedoplasty represents an effective and safe method, justifying the promotion of its use in the surgical management of otosclerosis.

Laser versus conventional fenestration in stapedotomy for otosclerosis: A systematic review

“…Articles published in Chinese were excluded . After selection based on title and abstract, and subsequent full‐text screening, 21 articles were initially considered eligible for answering our question. Cross‐reference checking revealed no additional articles.…”

“…Assessing all 21 studies, it was unclear whether all patients had undergone primary stapes surgery in three studies, more than one type of laser was used without performing subgroup analyses in one study, and air‐bone gap closure was not reported in six studies . In eight studies, the risk of bias was moderate, whereas it was high in the other 13. Adequate randomization, treatment allocation, and blinding were either not achieved or no information was provided regarding these criteria in any of the 21 included studies.…”

“…Adequate randomization, treatment allocation, and blinding were either not achieved or no information was provided regarding these criteria in any of the 21 included studies. Standardization of treatment was achieved in eight of the included studies and standardization of postoperative pure‐tone audiometry in 13 studies . In the studies that did not meet these criteria, laser settings were not adequately described or standardization of follow‐up duration was lacking.…”

“…Eight studies that carried moderate risk of bias were included for further review, of which six provided evidence of high directness and the other two of moderate directness . Air‐bone gap closure was not reported in the studies with moderate directness .…”

“…There are major dissimilarities between studies regarding type of laser, type of conventional fenestration technique, and follow‐up duration. In most studies, the CO 2 laser was used . However, different laser settings were used in these studies or it was not clear which settings were used (see Table for reported laser settings).…”