镫骨手术中自由光束型和光纤型CO激光传输系统的比较

Comparison of Free-Beam- and Fiber-Type CO Laser Delivery Systems in Stapes Surgery.

作者信息

Chang Mun Young, Choi Hyun Seok, Lee Sang-Youp, Koo Ja-Won

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.

Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

J Audiol Otol. 2017 Jul;21(2):103-106. doi: 10.7874/jao.2017.21.2.103. Epub 2017 Jul 5.

DOI:10.7874/jao.2017.21.2.103

PMID:28704897

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5516696/

Abstract

BACKGROUND AND OBJECTIVES

A free-beam-type CO 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 CO 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 CO 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 (=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 (=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 (=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 CO laser, while hearing outcomes did not differ significantly between the two groups.

摘要

背景与目的

一种自由光束型CO激光，使用安装在显微镜上的显微操作器作为传输系统，具有在射击时不受手部震颤影响的优点。然而，这种传输系统有几个缺点，包括操作范围受限和聚焦错误的风险。光纤型CO激光使用手持式传输系统，优缺点则相反。我们比较了使用自由光束和光纤型传输系统进行镫骨手术的结果。

对象与方法

本研究纳入了36例行镫骨切除术的患者，其中26例使用自由光束型CO激光，10例使用光纤型CO激光。评估气骨（AB）间隙闭合、骨传导（BC）变化和手术时间。AB间隙闭合通过术后气导阈值减去术前BC阈值来计算。BC变化通过术前BC阈值减去术后BC阈值来计算。

结果

光纤型组（72.5±8.2分钟）的平均手术时间显著（=0.035）短于自由光束型组（80.5±11.4分钟）。自由光束型组和光纤型组之间的平均AB间隙闭合无显著差异（=0.297）（分别为5.8±10.1和1.4±6.8 dB）。自由光束型组和光纤型组之间的平均BC变化无显著差异（=0.873）（分别为2.4±6.9和2.8±5.3 dB）。两组的听力结果无显著差异。