Thulium laser in stapedotomy surgery

Abstract

Background

Thulium laser use in stapedotomy surgery is usually associated with many doubts regarding the thermal effect on the vestibular area and the production of acoustic shock waves, which may result in permanent complications.

Objectives

We aimed to evaluate the efficacy and safety of the Thulium laser use in stapedotomy and its long-term effects on the clinical and audiological results.

Material and methods

It was a retrospective randomized case-series study. We included 148 otosclerosis patients. They were divided randomly into two groups; group A (multiple shots) included 62 patients and group B (one shot with a manual perforator) included 86 patients.

Results

There was a statistically significant improvement of the ABG in both groups. ABG closure (<10 dB) occurred in 87.1% of patients in group A, and 89.5% of patients in group B. Intraoperative complications were more in group B (p-value = 0.038). The postoperative complications were more in group A (p-value = .017).

Conclusions

According to our experience on a relatively large number of cases, the Thulium laser is a safe tool to be used in stapedotomy either in multiple shots or one shot with a manual perforator. It improved functional hearing efficiently without showing signs of inner ear impairment.

Chinese Abstract

背景：在镫骨切开术中使用铥激光通常会引起有关前庭区域热效应和声冲击波产生的许多疑问, 这可能会导致永久性并发症。

目的：我们旨在评估将铥激光用于镫骨切开术的有效性和安全性及其对临床和听力学结果的长期影响。

材料和方法：这是一项回顾性随机病例系列研究。我们纳入了148名耳硬化患者。他们被随机分为两组：A组（多次注射）有62名患者, B组（用手动穿孔器一次注射）有86名患者。

结果：两组患者ABG的改善均有统计学意义。A组87.1%的患者和B组89.5%的患者发生ABG闭合（<10dB）, B组术中并发症较多（p值=0.038）。A组术后并发症较多（p值=0.017）。

结论：根据我们治疗大量病例的经验, 铥激光是一种安全的工具, 可用于多发性镫骨切开术或手动穿孔器一次性镫骨切开术。它有效地改善了功能性听力, 而没有出现内耳损伤的迹象。

Keywords:

• Stapedotomy
• laser
• thulium
• audiology
• inner ear

Disclosure statement

No potential conflict of interest was reported by the author(s).