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

Wegner, Inge; Kamalski, Digna M. A.; Tange, R. A.; Vincent, Robert; Stegeman, Inge; Heijden, Geert J. M. van der; Grolman, Wilko

doi:10.1002/lary.24514

Cited by 68 publications

(65 citation statements)

References 33 publications

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“…Recently, Wegner et al [13] performed a meta-analysis on 999 cases of laser and non-laser stapes surgeries and found no obvious difference in postoperative ABG reduction or immediate postoperative vertigo, but the sense of tone for MF and HF sounds were better in the laser treatment group than the non-laser treatment group; additionally, the incidence of vertigo was lower [16] . The results obtained in this study also showed that the short-and long-term hearing results of the laser and non-laser group were not significantly different.…”

Section: Discussionmentioning

confidence: 99%

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Comparative Analysis of Laser and Non-Laser Stapes Surgeries

Gao²,

Tang³

et al. 2017

Int Adv Otol

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OBJECTIVE:This study aimed to observe differences in the efficacy of laser and surgical treatments of middle-ear conductive hearing loss (MECHL). MATERIALS and METHODS:A total of 276 ears of 267 patients with MECHL were divided into laser (n=172) and surgical (n=104) treatment groups according to the treatment method. Changes in the air-bone gap (ABG) after treatment and at the time of final follow-up were compared. An ABG value <20 dB was defined as effective and an ABG value <10 dB, significantly effective. The long-term treatment effects were also compared at the time of final follow-up. Additionally, postoperative adverse reactions were recorded for both the groups. RESULTS:The mean follow-up period was 76.77±43.62 months (range: 12-168 months). No significant difference in ABG was found between the two groups (21.31±11.64 dB vs. 19.14±9.79 dB, p>0.05). However, the laser treatment group showed slightly better results than the surgical treatment group at the final follow-up, although the difference between the groups was not found to be significant (11.69±9.98 dB vs. 12.62±10.94 dB, p>0.05). There was no difference in the long-term treatment effects between the two groups (effective: 87.21% vs. 88.46%, p>0.05; significantly effective: 55.81% vs. 56.73%, p>0.05). The incidence rates of postoperative adverse reactions were not significantly different. CONCLUSION:The treatment efficacy of laser and surgical treatments for MECHL are similar.

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Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis summarized that laser treatment offered advantages over non-laser methods, such as preventing footplate fracture and sensorineural hearing impairment [13] . However, a similar analysis remains to be conducted in China.…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Laser and Non-Laser Stapes Surgeries

Gao²,

Tang³

et al. 2017

Int Adv Otol

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“…Laser stapedotomy results in fewer footplate complications with better control during perforation [4] . Previous studies have shown successful hearing outcomes using laser stapedotomy.…”

Section: Discussionmentioning

confidence: 99%

“…SNHL is a very rare complication after stapedotomy. Inner ear injury due to direct trauma to the footplate via perforator usage or piston application, bacterial labyrinthitis, reparative granuloma, intralabyrinthine hemorrhage, and perilymphatic fistula are the possible causes [4,26] . The incidence of postoperative SNHL was reported to be between 0.2% and 3% in different studies and 1.4% in our study [16,27,28] .…”

Section: Discussionmentioning

confidence: 99%

“…Currently, surgical perforators, microdrills, and various types of laser are efficiently used in stapedotomy, although each technique has various advantages and disadvantages. Footplate fractures and sensorineural hearing (SNHL) loss were more frequent in conventional stapedotomy than in laser stapedotomy [4] . Recent data suggest that laser stapedotomy provides better hearing results compared to non-laser stapedotomy; however, subgroup analysis among the lasers was not available because of the lack of sufficient number of subjects [5] .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Videonystagmography and Audiological Findings after Stapedotomy; CO2 Laser vs Perforator

Karaca

Basut²,

Demir³

et al. 2016

Int Adv Otol

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OBJECTIVE:Various types of laser, microdrill, and perforator are effectively used in the surgical treatment of otosclerosis. However, they have certain disadvantages along with advantages. The aim of this study was to evaluate the effects of carbon dioxide (CO 2 ) laser and perforator stapedotomy techniques on audiological outcomes and postoperative vestibular functions via videonystagmography (VNG). MATERIALS and METHODS:This prospective and randomized clinical study was conducted in an academic tertiary medical center. Sixty-nine patients diagnosed with otosclerosis who underwent stapedotomy were enrolled in this study. Patients were divided into two groups based on the technique used in stapedotomy: CO 2 laser and perforator. Postoperative hearing gain and VNG findings were the main outcome measures. Subsequently, the two study groups were compared for analysis. RESULTS:The preoperative air-bone gap was 32.7±8.9 decibel (dB) in the study population and it was improved to 12.9±8.4 dB after operation. There were no differences in VNG findings and vertigo symptoms between the laser and perforator groups at postoperative day 2. There was no significant gain difference regarding the air conduction, bone conduction, and air-bone gap between the two groups (p=0.294, p=0.57, and p=0.37, respectively). CONCLUSION:Both CO 2 laser and perforator stapedotomy have successful audiological outcomes with no difference in postoperative vestibular disturbance.

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