Premium
Laser‐Assisted Endoscopic Stapedectomy: A Prospective Study
Author(s) -
Poe Dennis S.
Publication year - 2000
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200005001-00001
Subject(s) - footplate , stapes , medicine , stapedectomy , surgery , otosclerosis , biomedical engineering , materials science , middle ear , mechanical engineering , engineering
Objective To improve the techniques required to perform a stapedotomy without prosthesis (stapedioplasty). Study Design New infrared lasers were evaluated for potential use in otological surgery in guinea pigs. A prospective human trial of 34 primary stapes operations using the Argon ion laser was performed, with 11 stapedioplasties and 23 conventional stapedotomies as controls. Methods Laser–tissue interactions were evaluated for temporal bone and live guinea pig tissues, measuring crater histology and labyrinthine temperature elevations. Patients undergoing stapedioplasty had Argon ion laser cuts with endoscopic assistance made in the anterior crus and footplate to mobilize the posterior segment of the stapes while the anterior portion remained fixed. Results Diode laser (808‐nm) vaporization craters and temperature elevations in the vestibule were suitable for clinical use. Overall, stapedioplasty patients' hearing was improved with air‐bone gap closure to a mean of 8.3 dB (SD ± 9.8 dB). Conclusions Patients with anterior footplate otosclerosis are candidates for stapedioplasty preserving the annular ring and stapes tendon and eliminating prosthesis complications. High‐resolution small endoscopes, coupled with Argon ion or diode lasers promise to improve stapes visualization, enhancing the ability to perform minimally invasive surgery on the stapes footplate.