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CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(01): s00441801315
DOI: 10.1055/s-0044-1801315
Original Research

CO2 Laser Technique versus Cold Steel: Is CO2 Laser Required as a Surgical Tool for Flawless Stapes Surgery?

Vikas Kumar
1   Department of Otorhinolaryngology, Head and Neck Surgery, Army College of Medical Sciences, Brar Square, Delhi Cantonment, New Delhi, India
,
Anandita Gupta 
1   Department of Otorhinolaryngology, Head and Neck Surgery, Army College of Medical Sciences, Brar Square, Delhi Cantonment, New Delhi, India
,
A. Sethi
1   Department of Otorhinolaryngology, Head and Neck Surgery, Army College of Medical Sciences, Brar Square, Delhi Cantonment, New Delhi, India
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Funding The authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study.
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Abstract

Introduction Stapedotomy is the standard of care in the surgical management of clinical otosclerosis. It is a precise and technically demanding craft requiring impeccable surgical skills. Both conventional and laser-assisted procedures aim to achieve closure of the air-bone gap (ABG) with minimum collateral damage.

Objective To compare the postoperative outcomes of conventional stapes surgery and CO2 laser-assisted surgery.

Methods We conducted a retrospective analysis of the medical records of 74 adult patients who underwent stapedotomy at our center. The patients were divided into two groups for comparison: the “cold steel method” (CSM) group, which was composed of patients who had undergone conventional stapedotomy (manual microperforators/hand-held microdrill); and the “CO2 laser-assisted” (LA) group. The postoperative outcomes assessed at 3 and 6 months in both groups were analyzed and compared. The average operative time and complications of both groups were also compared.

Results The hearing outcomes presented statistically significant postoperative improvement in both groups. The LA group presented statistically significant better air conduction thresholds at 3 and 6 months (p < 0.05). The ABG and its degree of closure were statistically better at 3 months in the LA group; however, the difference became insignificant at 6 months. Transient vertigo was more common in the LA group (p < 0.01). There was no new sensorineural hearing loss in either group. The operative time was longer in the LA group.

Conclusion In experienced hands, both conventional and laser techniques can be used with equal ease and expectation of better outcomes. The CO2 laser is not an indispensable tool to achieve good surgical results on a routine basis.

Keywords

laser stapedotomy - conventional stapedotomy - otosclerosis - comparison - hearing gain

Authors' Contributions

VK: manuscript preparation, literature search, and data collection; AG: study conception, study design, manuscript preparation, literature search, and editing and revision of the manuscript; and AS: study conception, study design, and editing and revision of the manuscript.




Publikationsverlauf

Eingereicht: 07. Dezember 2022

Angenommen: 19. April 2023

Artikel online veröffentlicht:
22. Januar 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Vikas Kumar, Anandita Gupta, A. Sethi. CO2 Laser Technique versus Cold Steel: Is CO2 Laser Required as a Surgical Tool for Flawless Stapes Surgery?. Int Arch Otorhinolaryngol 2025; 29: s00441801315.
DOI: 10.1055/s-0044-1801315