The argon laser in surgery for chronic ear disease and otosclerosis

McGee, T. Manford

doi:10.1288/00005537-198309000-00014

Cited by 92 publications

(52 citation statements)

References 5 publications

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“…In average, the operation time reduced about onethird and the completion rate of stapes surgery increased about one-fifth after implementing diode laser in our department. Several studies have also demonstrated that regardless of devices used to create the stapedotomy (manual perforator, micro-drill or lasers) no significant difference in either post-operative ABG closure or postoperative sensorineural hearing loss can be found [4][5][6][7][8][9][10]. Some studies have shown that micro-drill is superior to manual perforator [14] and CO2-laser is superior to potassium-titanyl-phosphate (KTP) laser [15], but these improvements were not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…One of the most remarkable technical innovations was the introduction of lasers in stapes surgery already three decades ago [2,3]. However, several earlier and latter studies have shown no significant differences between laser-assisted, micro-drill and manual microsurgical stapedoplasty with regard to hearing outcome [4][5][6][7][8][9][10]. Instead of better hearing outcome, the micro-drill and/or laser appears to be very helpful to provide greater accuracy during precise manipulations and thereby reduce surgical trauma, which is important advantages regarding patients' safety compared to handheld instruments [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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Microdrill, Diode Laser, and Manual Microsurgical Stapedoplasty: A Comparative Study

Kasenõmm¹,

Suurna²

2014

IJOHNS

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Background: To evaluate hearing outcome, operation time and post-operative hospital stay after primary stapedoplasty with three different techniques: manual microsurgical, microdrill-assisted, and microdrill-and laser-assisted technique. Methods: A retrospective analysis of 150 consecutive cases of primary otosclerosis was operated by one surgeon. The patients were divided into three groups depending on the utilized surgical techniques: a fully manual microsurgical stapedoplasty (n = 56), microdrill-assisted stapedoplasty (n = 32), and microdrill-and laser-assisted stapedoplasty (n = 62). The mean pre-and post-operative air-bone gap was calculated by using pre-and post-operative mean pure tone air-and bone-conduction thresholds at 500, 1000, 2000 and 4000 Hz. Results: There were no statistically significant differences in the hearing outcome between the groups. The closure of air-bone gap and the improvement of the hearing were demonstrated in all study groups. Introduction of diode laser for stapes surgery resulted in significantly reduced operation time (about one-third) and the increase in the completion of surgery from 81.5% to 96.7%. At the same time, the rate of complications stayed low and hospital stay dropped from three days to one day. There were no major post-operative complications in any study groups. Conclusions: Application of diode laser in stapes surgery significantly reduced operation time and increased completion rate of surgery. No statistically significant difference was found between three surgical techniques regarding hearing outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Microdrill, Diode Laser, and Manual Microsurgical Stapedoplasty: A Comparative Study

Kasenõmm¹,

Suurna²

2014

IJOHNS

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“…He reported on cutting through middle ear adhesions and reshaping autogenous bony columellas during reconstruction of the ossicular chain [19]. Having used the argon laser in more than 500 tympanoplasties, McGee [20] also reported on his favourable experiences. The KTP laser which was developed in 1986 has become one of the most popular lasers in middle ear surgery [16,17].…”

Section: Discussionmentioning

confidence: 99%

KTP-532-Laser-Assisted Tympanoplasty

Gerlinger¹,

Pytel²

2001

Otorhinolaryngol Nova

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Objectives: The aim of this paper was to give a general review on appropriate applications (cutting, vaporization, coagulation) of the KTP laser in chronic ear surgery. Patients: Between December 1997 and December 2000, 46 laser-assisted tympanoplasties were carried out by the first author. Out of the 46 patients, 29 were female and 17 were male. The patients ranged in age from 4 to 66 years with a median of 32.5 years. Methods: The power of the laser applied was between 1 and 3 W, usually being 2 W. The mode of the application was either continuous or pulsing. In case of the latter mode, the length of the pulse was generally 0.2 s. The laser light was directed to the microscopic field with a flexible fiber scope by means of a hand-held probe. The diameter of the fiber scope was 0.2 mm. Results: Of the 32 patients who underwent combined-approach tympanoplasties, 19 had already undergone a second-look procedure. Residual cholesteatoma pearls were found in 2 cases (10%). The remaining 14 patients underwent laser-assisted myringoplasties. Neither facial palsy nor sensorineural hearing loss occurred. No postoperative infection or vertigo was noted. Five patients experienced moderate postoperative pain after the third postoperative day. Conclusions: The authors’ impression is that the KTP laser allows excellent haemostasis during chronic ear surgery and enables the surgeon to obtain a more effective disease removal in a bloodless field. Using the laser, cochlear trauma can be avoided.

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“…Die Laserstapedotomie weist gegenüber der konventionellen Stapedotomie einige Vorteile auf. So konnten klinische Studien zeigen, dass die Laserstapedotomie im Vergleich zu konventionellen Eingriffen weniger Innenohrschädi-gungen und vestibuläre Störungen verursacht [6,15,29,34,45,53].…”

Section: Historische Entwicklungunclassified

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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The argon laser in surgery for chronic ear disease and otosclerosis

Cited by 92 publications

References 5 publications

Microdrill, Diode Laser, and Manual Microsurgical Stapedoplasty: A Comparative Study

Microdrill, Diode Laser, and Manual Microsurgical Stapedoplasty: A Comparative Study

KTP-532-Laser-Assisted Tympanoplasty

Laserstapedotomie

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