Long-term results of the Er-Yag laser used in stapes surgery.

Stapes surgery is performed using both conventional techniques and a variety of laser systems. The Er-Yag laser is a type of pulsation laser deemed by many to be the safest for ear surgery. The aim of this study was to assess the long-term effects of using the Er-Yag laser in stapes surgery and its impact on inner ear function. The study was conducted on 95 ears (48 right and 47 left) that had undergone Er-Yag laser-assisted stapedotomy. The follow-up time was at least 3 years. Pure tone audiometry was performed on all patients. The frequency ranged from 125 to 8,000 Hz. Air conduction and bone conduction were both assessed. Moreover, all patients had their stapedius reflex assessed and were given a Rinne test. The results were evaluated according to the Committee on Hearing and Equilibrium guidelines and then statistically analyzed using the Wilcoxon sequence pair test with a p value of <0.05. A decrease in the hearing threshold of 0.5, 1, and 3 kHz, for both bone and air conduction was observed for all patients (p < 0.0001). The Wilcoxon sequence pair test revealed a statistically significant correlation between the pre- and postoperative treatment mean air-bone gap values (p < 0.0001). No facial nerve paralysis was observed. No Er-Yag laser side effects were observed on inner ear function. The patients also had lower hearing thresholds. These observations demonstrate the usefulness of Er-Yag lasers in stapes surgery.

[Stapedotomie with the use of CO2 laser--"one shot" technique]. / Stapedotomia z uzyciem lasera CO2--technika jednego strzalu.

INTRODUCTION: CO2 laser is used in stapes surgery due to good water absorption and quite optimal ablation of a bony structure without the influence of inner ear parameters. AIM OF THE STUDY: the assessment of the influence of CO2 - "one shot" laser on hearing results in the patients group with otosclerosis. MATERIAL AND METHOD: The study was carried out on a patients group after surgical treatment. The follow up time was at least 6 months. The hearing results were described according to the guidelines of the American Committee on Hearing and Equilibrium. The obtained results were statistically analysed with the use of the Wilcoxon sequence pair test. RESULTS: The CO2 - "one shot" laser has been used in Department of Otolaryngology in Poznan since July 2009. Using this system 101 operations were carried out to the end of December 2011. 54 patients were in the analysed group, there were 40 women and 14 men, the age range from 22 to 59. In the Wilcoxon sequence pair test there was a statistically significant correlation between the value of the hearing threshold in pre- and post-operative examinations at 0.5, 1, 2 and 3kHz for bone and air conduction. We found also a statistically significant correlation between the mean value of the air-bone gap before and after treatment. In the group after the surgery the cochlear reserved became closed or decreased (p<0.001). CONCLUSION: based of the hearing results we found great usefulness of CO2 - "one shot" laser in stapes surgery.

Comparison between 2 laser systems, Er-Yag and CO2, in stapes surgery.

OBJECTIVE: The aim of the study was to compare 2 laser systems, Er-Yag and CO2, in stapes surgery. STUDY DESIGN: The study design was retrospective. SETTING: The study was conducted at an academic tertiary referral center. PATIENTS: There were 88 women and 34 man in the analyzed group. The study was carried out on 142 ears: 52 on the right ear, 50 on the left ear, and 20 bilateral. Forty-seven ears underwent a CO2 laser-assisted stapedotomy, and 95 underwent Er-Yag-assisted stapedotomy; 23 left and 24 right ears were operated on using the CO2 laser. The Er-Yag laser was used in 48 right and 47 left ears. The follow-up time was at least 1 year. RESULTS: When the postoperative air-bone gap was compared with the preoperative air-bone gap for the 2 laser systems using the Student t test, as well as the Mann-Whitney U test, no statistical differences were found between the 2 groups, that is, with the use of Er-Yag and CO2 lasers. Also, no statistically significant differences were measured over all frequencies by the Student t test between preoperative and postoperative bone conduction in each group. CONCLUSION: To sum up, our observations have proven the usefulness of 2 laser systems: CO2 and Er-Yag lasers in stapes surgery. In both groups, a decrease in the hearing threshold was obtained.

Variable course of progression of oral cavity and oropharyngeal carcinoma in young adults.

AIM OF THE STUDY: The main aim of this article is the epidemiological analysis of patients treated due to oral and oropharyngeal cancer, with a special interest in the group under the age of 40, evaluation of the differences in the clinical course of the disease as well as assessment of the treatment results, regarding the age of the affected individuals. MATERIAL AND METHODS: 523 individuals affected by oral and oropharyngeal cancer who were treated in the Otolaryngology and Laryngeal Oncology Department between 2000 and 2008. Precise analysis was performed on 360 out of 523 affected individuals, in whom full clinical status was determined; 13 patients were young adults. The retrospective analysis was created based on case histories, surgical protocols and emergency records. RESULTS: In young adults there is a markedly increased risk of organ involvement according to the Mann-Whitney U-test analysis (p = 0.044907). The probability of recurrence in the group of young adults is also much higher. Analysis of Kaplan-Meier test results indicated that the chance for the lack of recurrence within a 6-month period was 85.7%; however, the risk of recurrence increased, and after 12 months was equal to the arithmetic data (50%). CONCLUSIONS: Among young adults there is an increased risk of local recurrence following 12 months after surgical intervention. According to our observations, despite rapid progression and early recurrence in young adults (4/7) the prognosis for both groups is not statistically different.