Long-term follow-up after “one-shot” CO2 laser stapedotomy: is the functional outcome stable during the years?

Abstract

The use of "one-shot" CO laser technique for a primary small-fenestra stapedotomy is well established, but few papers report the long-term functional results. We retrospectively reviewed medical records of 198 patients, treated for otosclerosis from January 2008 to December 2011, at the Department of Head and Neck Surgery, Catholic University of Rome. Statistical comparison between audiological thresholds obtained 24 h preoperatively, at early (4 weeks) and late postoperative examinations (mean time 45 months), was performed. Comparison of preoperative vs both early and late postoperative ACPTA showed a statistically significant difference (respectively 55 vs 33 and 31 dB; p < 0.001). No statistical difference was observed between preoperative, early and late postoperative BCPTA (respectively 23 vs 23 and 22 dB; p > 0.05). Both early and late postoperative ABG improved significantly compared to the preoperative one (respectively 10 and 9 vs 32 dB; p < 0.001). No statistical difference was found in comparison of early vs late postoperative ACPTA (respectively 33 vs 31 dB; p > 0.05), early vs late postoperative ABG (respectively 10 vs 9 dB; p > 0.05) and early vs late ABG gain (respectively 22 vs 23 dB; p > 0.05). No subjects developed postoperative complications requiring revision surgery or late deterioration of hearing threshold. The analysis of our data suggests that "one-shot" CO laser stapedotomy is an effective and safe procedure: it allows a rapid stapedotomy without damages for the inner ear and optimal functional results that remain stable during the years.

The impact of intra-operative factors in otosclerosis outcomes: retrospective study in a tertiary centre

“…The population of the present study achieved satisfactory functional results, with a mean post-operative ABG of 9.5 dB and a post-operative ABG lower than 20 dB in 93% of cases, in agreement with our previous reports 1221 . Moreover, mean BCPTA improved by 1.7 dB and permanent complications were never reported.…”

Does the diameter of the stapes prosthesis really matter? A prospective clinical study

“…Because stapes surgery is a highly successful procedure, it is common to have patients lost at follow‐up if the first evaluation is at more than 1 month, especially in a tertiary referral center where patients are referred from all over France. In any case, the value of results at 1 month has been validated in several studies …”

“…In any case, the value of results at 1 month has been validated in several studies. 12,[19][20][21] This study also has some limitations. First, no randomization was performed because the 0.6-mm piston was not immediately available in France; however, the use of sequential patients could reduce the risk of bias due to the nonrandomization, as has been shown by the complete absence of differences between the two groups when considering the demographic and audiological data.…”

How Long Is Otosclerosis Surgery Effective? Hearing Results after a 22-Year Follow-Up

“…Other articles confirm a variable rate of hearing aid prescription (20-54%) [Faye-Lund et al, 1984;Lars Lundman et al, 1999;Gillard and Harris, 2020]. Majority of the recent studies suggest that better results can be achieved through the use of lasers, especially by "one-shot" CO 2 laser stapedotomy [Sergi et al, 2016]. It will be interesting to determine what are the long-term results of laser stapedotomy, to verify if the theoretical higher clinical safety due to the lower involvement of labyrinthine structures translates into a stable long-term result.…”