CO2 Laser Stapedotomy / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: CO2 laser is known to have optimal tissue characteristics for stapes surgery though it has suboptimal optical characteristics. Surgical experience of stapes surgery using CO2 laser has not been previously reported in Korea. In this study, authors assessed the functional outcomes of stapes surgery using CO2 laser and evaluated its merits and drawbacks. SUBJECTS AND METHOD: We retrospectively reviewed the medical records of 25 patients (28 ears) who underwent CO2 laser stapedotomy between November 2003 and December 2007. The patient's mean age was 42 years (range, 15-70), with the patients consisting of 11 males and 14 females. Follow-up duration ranged from 6 to 49 months and the mean observation time was 18.2+/-13.2 months. Hearing improvements at the final examination were evaluated by airbone gap closure. RESULTS: The pre-operative mean bone conduction threshold, air conduction thresholds and mean air-bone gap were 21.0+/-8.8 (mean+/-SD) dB, 51.3+/-7.2 dB and 30.1+/-7.8 dB, respectively. After stapedotomy, the mean bone conduction and air conduction thresholds were 20.5+/- 9.7 dB, 30.6+/-16.1 dB, respectively, and the mean air-bone gap was 10.1+/-7.1 dB at the last audiologic follow-up. The 'best results' were 18 cases (64.3%) and 'good results' were 8 cases (28.6%). The overall "succeccful" hearing improvement was achieved in 26 ears (92.9%). One case was classified as 'failure' and two cases developed post-operative benign paroxysmal positional vertigo. CONCLUSION: 92.9% of patients achieved satisfactory hearing results using CO2 laser stapedotomy. Although the manipulation of CO2 laser is difficult and limitation in gaining the anterior crus exposure maybe encountered due to suboptimal optical properties, these difficulties were not influential in gaining expertise of the instrument.