Endoscopic stapedotomy: A comparison between the conventional approach versus CO 2 laser-assisted surgery.

BACKGROUND: Although the utility of laser fiber in microscopic stapes surgery has been documented in the past, their role can be highly emphasized in endoscopic stapes surgery, especially in difficult anatomical situations.

METHODS: This is a retrospective analysis of cases where a total of 46 patients (22 in conventional stapedotomy and 24 in CO2 laser-assisted stapedotomy) were included in the study. The clinical parameters were assessed both in the preoperative and postoperative periods in the respective groups and later compared 12 weeks after stapedotomy.

RESULTS: A total of 90.90% (20/22) of the patients in the conventional stapedotomy and 95.83% (23/24) of patients in laser-assisted stapedotomy had <20 dB of AB gap in the postoperative period ( P  = 0.71). Canaloplasty was required in six patients in the conventional stapedotomy and none of the patients in the laser group needed the same ( P  = 0.01). Chorda tympani nerve was manipulated in 59.09% (13/22) and 25.00% (6/24) of cases in the conventional group and in the CO2 laser group, respectively ( P  = 0.01).

CONCLUSION: Although the audiological outcomes with fiber-enabled CO2 laser in endoscopic stapedotomy are comparable to conventional surgery, it is a better tool in a narrow auditory canal, requiring minimal manipulation of the chorda tympani nerve.