Comparing Hearing Outcomes in CO² Laser Stapedotomies and Routine Stapedotomies

Background Hearing loss in otosclerosis is caused due to abnormal bone growth in the otic capsule. The current standard of care for surgical management of otosclerosis is small fenestra stapedotomy, which can be done using CO² lasers or by conventional methods. In this case series, we assessed postoperative hearing outcomes in patients who underwent LASER stapedotomies and compared them to patients who underwent the classical method of stapedotomies.

Aim To assess whether laser stapedotomies are superior to classical stapedotomies in terms of hearing outcome.

Methods The medical charts of four patients who underwent laser stapedotomies were retrospectively reviewed and compared with four age-matched controls who underwent classical stapedotomies.

Results The postoperative air conduction thresholds and air–bone gaps at 250, 500, 1,000, 2,000, and 4,000 Hz were studied. There was found to be no statistically significant difference in the postoperative hearing between the two groups.

Conclusion There appears to be no significant difference in the postoperative hearing outcomes irrespective of the surgical method used.

Clinical Significance Otosclerosis is one of the causes for conductive hearing loss in several Indian patients. The use of CO2 laser has been rising recently owing to its no touch principle and high precision. However, the cost for the patient as well as the hospital has increased greatly by the use of lasers. As the main outcome for a successful stapedotomy is improvement in hearing, the decision of which method to use should be based on clinical factors and financial ability of the patients.