The application of the modern high-energy laser technologies for the surgical treatment of the patients presenting with otosclerosis

The objective of the present study was to characterize the effectiveness of the audiological and radiological diagnostic techniques as well as the results of the surgical treatment of the patients presenting with otosclerosis based at the hospital clinic of the Pacific State Medical University. The analysis included 49 surgical interventions for stapedoplasty carried out on 42 patients during the period from 2015 to 2017. The tympanic form of the disorder was diagnosed in 51.02% of the cases, the mixed form I in 16.28%, and the mixed form II in 32.7%. The excellent results within two months after surgery were obtained in 87.2% of the treated patients, the good and satisfactory results in 8.72% and 4.08% of them respectively.

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The diagnostics and surgical treatment of the patients presenting with otosclerosis in the Primorye Territory

Gilifanov

Lepeiko²,

Andreeva

et al. 2018

Vestn. otorinolaringol.

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Evolution of methods of assistance in stapes surgery in patients with otosclerosis

2023

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Introduction. It is not always possible to create a perforation in the footplate of the stirrup with the help of classical microinstruments during stapedoplasty, which will exactly correspond to the required parameters, moreover, these tools can be dangerous in some cases, since it is possible to provoke the footplate to enter the ear labyrinth, mobilizing it.Aim. To determine the efficacy and safety of various methods of stapes surgery in otosclerosis with an assessment of the frequency of intra- and postoperative complications.Materials and methods. In the Clinic of Ear, Throat and Nose Diseases of the I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University) a number of experimental and clinical studies were conducted, partial results of which we decided to retrospectively compare and analyze. The data of the first group of patients were taken from the results of a study with a CO2 laser. The data of the second group of patients were obtained from the results of a study with a diode (blue) laser with a wavelength of 445 nanometers. The data of the third group of patients were collected from archival data of medical histories from 2020 to 2022, who used a set of micro-tools for stapedoplasty (manual micropeforator, microneedle).Results. The data obtained showed similar results in the CO2 and blue laser groups. The main difference in the group of patients who underwent stapedoplasty with classical microinstruments was a longer operation time compared to laser stapedotomies, as well as a greater number of intraoperative difficulties associated with the mobilization of the foot plate of the stapes during manipulations with a manual perforator.Conclusions. The use of blue laser and CO2 laser in stapedotomy procedures shows promising results in terms of surgical accuracy and speed of the operation. Further research should compare the long-term effects of these three methods to determine the most effective and safest.

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Physical justification of the safety of using a surgical laser with a wavelength of 445nm during stapedoplasty

Svistushkin,

Sinkov,

Sobolev

et al. 2024

Aspirantskiy Vestnik Povolzhiya

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Introduction. Surgical lasers with different wavelengths are used in the surgical treatment of patients with otosclerosis. There are undoubted advantages of using surgical lasers during stapedoplasty at its various stages. At the same time, there is a risk of negative consequences for the structures of the inner ear due to the transition of light energy into thermal energy. Currently, the search for modern optimal surgical lasers for stapedoplasty continues. Aim ofthe study. To substantiate the safety of using a laser beam with a wavelength of 445nm during stapedoplasty using an experimental physical model. Materials and methods. Together with physicists from the Russian Engineering Club LLC, a physical experimental model was created to theoretically substantiate the use of a surgical laser with a wavelength of 445nm during stapedoplasty at its various stages. Results. Based on the physical calculations carried out during our study, we came to important conclusions regarding the effect of laser radiation on the structures of the inner ear during the stapedoplasty process. It was found that even if the value of the parasitic (damaging) radiation energy is 10 W (maximum value) with an average pulse duration used for perforation of the footplate of the stirrup is 0.15 s, then its effect will not lead to any significant thermal effect on the perilymph. Conclusions. The obtained data serve as a basis for further research and improvement of laser technologies in the field of otosurgery. As part of our study, we anticipate the need for additional histological analysis based on the results obtained. Despite encouraging findings regarding the safety of parasitic laser radiation in the context of thermal exposure to perilymph, histological examination represents an important next step for a deeper understanding of structural changes in the tissues of the inner ear.

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The application of the modern high-energy laser technologies for the surgical treatment of the patients presenting with otosclerosis

Cited by 3 publications

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The diagnostics and surgical treatment of the patients presenting with otosclerosis in the Primorye Territory

The diagnostics and surgical treatment of the patients presenting with otosclerosis in the Primorye Territory

Evolution of methods of assistance in stapes surgery in patients with otosclerosis

Physical justification of the safety of using a surgical laser with a wavelength of 445nm during stapedoplasty

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