J Audiol Otol.  2017 Jul;21(2):103-106. 10.7874/jao.2017.21.2.103.

Comparison of Free-Beam- and Fiber-Type COâ‚‚ Laser Delivery Systems in Stapes Surgery

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. jwkoo99@snu.ac.kr
  • 3Research Center for Sensory Organs, Medical Research Center, Seoul National University, Seoul, Korea.

Abstract

BACKGROUND AND OBJECTIVES
A free-beam-type COâ‚‚ laser, which use a micromanipulator mounted on a microscope as the delivery system, has the merit of not being affected by hand tremor at the time of shooting. However, this delivery system has several disadvantages, including a restricted operation range and a risk of incorrect focusing. A fiber-type COâ‚‚ laser uses a hand-held delivery system and has the opposite merits and demerits. We compared the results of stapes surgery with free-beam and fiber type delivery systems.
SUBJECTS AND METHODS
The study enrolled 36 patients who underwent stapedotomy with free-beam- (n=26) or fiber- (n=10) type COâ‚‚ lasers. The air-bone (AB) gap closure, bone conduction (BC) change, and operating time were evaluated. The AB gap closure was calculated by subtracting the preoperative BC thresholds from the postoperative air conduction thresholds. The BC change was calculated by subtracting the postoperative BC thresholds from the preoperative BC thresholds.
RESULTS
The mean operating time was significantly (p=0.035) shorter in the fiber-type group (72.5±8.2 min) than in the free-beam-type group (80.5±11.4 min). The mean AB gap closure did not differ significantly (p=0.297) between the free-beamand fiber-type groups (5.8±10.1 and 1.4±6.8 dB, respectively). The mean BC change did not differ significantly (p=0.873) between the free-beam- and fiber-type groups (2.4±6.9 and 2.8±5.3 dB, respectively). The hearing outcomes did not differ significantly between the two groups.
CONCLUSIONS
Operating times were significantly shorter using the fiber-type COâ‚‚ laser, while hearing outcomes did not differ significantly between the two groups.

Keyword

Stapedotomy; COâ‚‚ laser; Otosclerosis; Bone conduction

MeSH Terms

Bone Conduction
Hand
Hearing
Humans
Otosclerosis
Stapes Surgery*
Stapes*
Tremor
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