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CO2 laser stapedotomy safety: influence of laser energy and time on bone-conduction hearing levels

  • Otology
  • Published:
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Abstract

Total laser energy in CO2 stapedotomy depends on the laser settings and the amount of applications. It is unclear if the amount of total laser energy affects bone-conduction hearing thresholds and if possible effects are temporary or permanent. Alterations of bone-conduction hearing thresholds after single or multiple-shot CO2 laser stapedotomy were analyzed between 1 and 3 weeks and 1.5–6 months after primary (n = 501) or revision surgeries (n = 153) and correlated to time, laser energy, frequency, surgical technique, and pathology encountered in revision stapedotomy. In both time periods, most patients showed a lower bone-conduction threshold in the four-tone puretone average (PTA) at frequencies of 0.5, 1, 2, and 3 kHz that further improved over time. Between 1 and 3 weeks, the improvement was significant in subgroups with cumulative energies lower 1 J and successful one-shot technique or in revisions without laser application. The remaining subgroups with higher total energies showed significant improvements between 1.5 and 6 months. At 4 and 8 kHz, significant improvements were found during 1.5–6 months after primary and revision surgery independent of the used energy. Repeated CO2 laser applications showed no impairment in bone-conduction thresholds and can thus be considered as safe. In most patients, significant, yet unexplained, improvements in bone-conduction hearing thresholds were noticed in a time- and energy-related pattern.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, 12200, Berlin, Germany

    Uwe Schönfeld, Hu Weiming, Veit M. Hofmann & Andreas E. Albers

  2. Krankenhaus Bethel Berlin and Private Practice, Promenadenstr. 3-5, 12207, Berlin, Germany

    Sergije Jovanovic

Authors
  1. Uwe Schönfeld
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  2. Hu Weiming
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  3. Veit M. Hofmann
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  4. Sergije Jovanovic
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  5. Andreas E. Albers
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Correspondence to Andreas E. Albers.

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The study has been approved by the ethical board of Charité-Universitätsmedzin Berlin.

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Schönfeld, U., Weiming, H., Hofmann, V.M. et al. CO2 laser stapedotomy safety: influence of laser energy and time on bone-conduction hearing levels. Eur Arch Otorhinolaryngol 274, 4131–4139 (2017). https://doi.org/10.1007/s00405-017-4769-3

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  • DOI: https://doi.org/10.1007/s00405-017-4769-3

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