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“Air-bone gap” closure after primary and revision- CO2 laser stapedotomy with the “one-shot” technique during the first year
18 April 2018 (online)
The one-shot CO2 laser stapedotomy is an established procedure to treat otosclerosis routinely used during the past 15 years for primary (P-LS) and revision laser stapedotomy (R-LS).
Study-aim was to demonstrate the dynamics of the air-bone-gap (ABG) within the first year. For this, a prospective analysis of audiogramms from 501 P-LS and 153 R-LS obtained from three postoperative intervals (3 – 6 weeks, 3 – 6 months and 1 year) were compared to preoperative results. For statistics, the pure-tone-average (PTA) was calculated from four frequencies.
One year postoperatively, in both groups a significant improvement of the ABG was found: P-LS: 0 – 10dB 64%, 11 – 20dB 32%,> 20dB 4% and R-LS: 0 – 10dB 48%, 11 – 20dB 46%, 21 – 30dB 6%. The individual ABG-improvement was one year postoperatively 18.8dB for the P-LS and 21.3 dB for the R-LS. Within the first year, the comparison of the 3 postoperative intervals resulted neither for the P-LS nor the R-LS (P-LS: median 8.5dB, R-LS: median 13.8dB, 12.5dB and 12.5dB) in significant changes in the ABG (PTA).
Also, there was no difference regarding the ABG between the groups with one laser or multiple laser applications. The 1-year results were not affected by the extent of the preoperative ABG.
(Subgroups preoperative: 0 – 10, 10 – 20, 20 – 30 and > 30dB; P-LS: p = 0,4, R-LS: p = 0,14).
Thus, on average, there were no significant differences in the postoperative ABG between P-LS and R-LS, and patients benefit equally from the procedure. The improvement in hearing was already at the maximum level in the early postoperative phase and was independent from the preoperative ABG.