ハンドピース型CO<sub>2</sub>レーザーを使用したアブミ骨手術の検討 [in Japanese] Outcomes of Stapes Surgery Using the Fiber-enabled CO<sub>2</sub> Laser [in Japanese]
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Small-fenestra stapedotomy (SFS) is generally regarded as a first-choice procedure in terms of minimizing postoperative dizziness and improving hearing levels. However, otosclerotic changes to the footplate are relatively mild in most Japanese patients. The CO<sub>2</sub> laser has been widely used for management of the nasal mucosa in Japan. This study examined whether the CO<sub>2</sub> laser could cut the crus bones to keep the footplate in place. This study evaluated data from 63 patients who had undergone stapes surgery with the CO<sub>2</sub> laser between October 2010 and December 2013. A transcanal approach was adopted under general anesthesia. The stapes tendon and posterior crus were cut with the CO<sub>2</sub> laser. The anterior crus was cut with the laser or was fractured. A Skeeter<sup>TM</sup> drill or CO<sub>2</sub> laser was used to open the stapes footplate, and a piston was then inserted. SFS was performed in 50 patients (79%), partial stapedectomy in 9 (14%) and total stapedectomy in 4 (6%). Between 1999 and 2009, SFS was performed in 54 of 97 patients (56%), partial stapedectomy in 26 (27%), and total stapedectomy in 17 (18%). The postoperative air-bone gap was ≤10 dB in 33 cases (79%), 11-20 dB in 8 cases (19%), and >30 dB in 1 case. The rate of stapedotomy was significantly increased compared with the procedure without using a CO<sub>2</sub> laser. Therefore, these results suggest that a CO<sub>2</sub> laser can be used to cut the stapes crus during stapedotomy.
- Practica Oto-Rhino-Laryngologica
Practica Oto-Rhino-Laryngologica 107(10), 783-787, 2014
The Society of Practical Otolaryngology