Flexible Fiber Optic Carbon-Dioxide Laser Assisted Stapedotomy in Otosclerosis

Abstract

Objective. The aim of this study is to analyze the hearing and vestibular outcome of patients with otosclerosis who have been operated on by fiber optic flexible CO₂ laser.

Study Design. A preliminary and retrospective study was conducted in 30 patients with otosclerosis.

Results. Comparative analysis of average air conduction thresholds (53.41 ± 11.81 dB versus 26.37 ± 11.04 dB) and air-bone gaps (34 ± 9.92 dB versus 12.03 ± 6.02 dB) before and after the surgery were statistically significant (<0.001). Air-bone gap closed within 10 dB or less in 50% of the cases and within 20 dB or less in 90% of the cases. Average bone conduction threshold after the surgery (16.68 ± 12.00 dB) was better than that before the surgery (20.13 ± 8.59). However, no statistically significant difference was found (p = 0.213). One patient had tinnitus after surgery. None of the patients had severe sickness or vomiting due to surgery. Eleven patients (36.6%) had very mild nystagmus beating toward the counter-lateral side. All patients were stable at 10 days after surgery.

Conclusion. The results indicate that fiber optic flexible CO₂ laser provides the surgeon with a very safe and precise surgical instrumentation even in cases with extensive and obliterative otosclerosis.