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. 2023 Mar 23;8(2):561-567.
doi: 10.1002/lio2.1045. eCollection 2023 Apr.

The utility and safety of diode laser in endoscopic stapes surgery

Yuvatiya Plodpai  1
Affiliations

The utility and safety of diode laser in endoscopic stapes surgery

Yuvatiya Plodpai. Laryngoscope Investig Otolaryngol. .

Abstract

Objective: The advantages of laser stapedotomy are less trauma and more precise and minimally invasive techniques; however, the potential risk of overheating from the laser combined with the endoscope tip must be considered. This study aimed to assess the efficacy and safety of diode lasers for endoscopic stapes surgery.

Methods: A retrospective review of 56 patients with otosclerosis who underwent primary endoscopic stapedotomy with a diode laser from 2017 to 2020 was conducted. Demographic data, intraoperative findings, preoperative and postoperative audiological assessments, and postoperative complications were analyzed.

Results: There was no statistically significant difference between the preoperative and postoperative bone conduction thresholds. The mean postoperative air-bone gap (ABG) improved significantly compared to the preoperative ABG (4.07 vs. 35.43 dB, p < .001). The postoperative ABG closure within 10 dB at 6 and 12 months was achieved in 87.50% and 91.07% of patients, respectively. The postoperative pain scores at 4 and 24 h were 2.55 and 0.39, respectively. Immediate postoperative vertigo was reported in 12.50% of patients, with 100% complete recovery 2 months after surgery. The chorda tympani nerve was preserved in all the cases. Postoperative taste disturbances at 2 and 12 months were observed in 17.86% and 1.79% of patients, respectively.

Conclusion: The diode laser in endoscopic stapedotomy is a safe and effective technique that provides satisfactory hearing outcomes. Temporary taste disturbances during the early postoperative period are a concern. The handheld diode laser delivery system is suitable for an endoscopic approach and is an alternative armamentarium for the treatment of otosclerosis. Level of evidence: IV.

Keywords: diode; endoscopic ear surgery; laser; stapedotomy; stapes surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
(A) Endoscopic view of an adequate exposure for performing stapes surgery. (B) Stapedial tendon cauterized using a diode laser. (C) The posterior crus of stapes cauterized using a diode laser. (D) Exposure of a stapes footplate after removing the stapes suprastucture.
FIGURE 2
FIGURE 2
(A) Footplate fenestration using a diode laser. (B) Polishing and creation of a sharp round shape fenestra using a 0.7‐mm microdrill.
FIGURE 3
FIGURE 3
Box plot showing the postoperative visual analog scale score of the diode laser‐assisted endoscopic stapedotomy.
See this image and copyright information in PMC

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References

    1. Bennett ML, Zhang D, Labadie RF, Noble JH. Comparison of middle ear visualization with endoscopy and microscopy. Otol Neurotol. 2016;37(4):362‐366. - PubMed
    1. Hall AC, Mandavia R, Selvadurai D. Total endoscopic stapes surgery: systematic review and pooled analysis of audiological outcomes. Laryngoscope. 2020;130(5):1282‐1286. - PubMed
    1. Koukkoullis A, Tóth I, Gede N, et al. Endoscopic versus microscopic stapes surgery outcomes: a meta‐analysis and systematic review. Laryngoscope. 2020;130(8):2019‐2027. - PubMed
    1. Manna S, Kaul VF, Gray ML, Wanna GB. Endoscopic versus microscopic middle ear surgery: a meta‐analysis of outcomes following tympanoplasty and stapes surgery. Otol Neurotol. 2019;40(8):983‐993. - PubMed
    1. Hajiioannou J, Gkrinia E, Tzimkas‐Dakis K, et al. Microscopic versus endoscopic stapes surgery: a systematic review and metanalysis. J Laryngol Otol. 2022;11:1‐9. - PubMed

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