Poletti Arturo M, Miceli Stefano, Rossi Vanessa, Di Pietro Susanna, Tosi Giovanni, Colombo Giovanni
1 Department of Otorhinolaryngology, Humanitas Clinical and Research Hospital , Rozzano, Milan, Italy .
2 Medical Physics Department, Humanitas Clinical and Research Hospital , Rozzano, Milan, Italy .
Photomed Laser Surg. 2015 Dec;33(12):598-603. doi: 10.1089/pho.2015.3890. Epub 2015 Sep 23.
The purpose of this study was to evaluate the effectiveness and the safety of diode laser stapedotomy, through the functional results analysis.
A total of 179 primary cases of otosclerosis that had been operated on with a diode laser technique from 2004 to 2012 were retrospectively reviewed. Preoperative, 1 month postoperative, and late annual follow-up audiograms (up to 8 years) were obtained in all the cases. Mean preoperative and 1 month postoperative pure-tone average (500-1000-2000-4000 Hz) bone conduction thresholds (PTA-BCs), air conduction (AC) hearing outcomes for 8 kHz and mean postoperative air-bone gap (PTA-ABG) closure were analyzed.
The mean preoperative (pre) PTA-BC was 24.22 dB (±8.7 SD) whereas the mean postoperative (post) PTA-BC was 21.11 dB (±9.1 SD). The mean preoperative 8 kHz AC was 56.41 dB (±22.86 SD) and the postoperative 8 kHz AC was 52.56 dB (±24.35 SD). A statistically significant improvement of the PTA-BC post and of the postoperative 8 kHz AC was observed. The 1 month ABG closure within 10 dB in 89.02% of the patients and within 20 dB in 97.69% of the patients was obtained with statistically significant stability over long-term follow-up. No major complications occurred in the series.
The use of diode laser with high power and short time exposure as setup can be considered a safe, precise, and useful tool in stapes surgery.
本研究旨在通过功能结果分析评估二极管激光镫骨切除术的有效性和安全性。
回顾性分析了2004年至2012年期间采用二极管激光技术进行手术的179例原发性耳硬化症病例。所有病例均获得术前、术后1个月及每年的晚期随访听力图(最长8年)。分析了术前及术后1个月的纯音平均听阈(500 - 1000 - 2000 - 4000Hz)骨导阈值(PTA - BCs)、8kHz气导(AC)听力结果以及术后平均气骨导间距(PTA - ABG)闭合情况。
术前平均PTA - BC为24.22dB(±8.7标准差),术后平均PTA - BC为21.11dB(±9.1标准差)。术前平均8kHz AC为56.41dB(±22.86标准差),术后8kHz AC为52.56dB(±24.35标准差)。观察到术后PTA - BC及术后8kHz AC有统计学意义的改善。89.02%的患者术后1个月气骨导间距闭合在10dB以内,97.69%的患者闭合在20dB以内,且在长期随访中具有统计学意义的稳定性。该系列未发生重大并发症。
使用高功率且曝光时间短的二极管激光装置可被视为镫骨手术中一种安全、精确且有用的工具。