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Laser vs drill for footplate fenestration during stapedotomy: a systematic review and meta-analysis of hearing results

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Abstract

Objective

Stapes surgery is the gold standard surgical treatment nowadays for otosclerosis. Several controversies on the procedure have been reported; surgical techniques for most favorable outcomes are still on discussion. The objective of this study is to present an update of evidence-based medicine concerning the utilization of lasers and drilling for footplate fenestration during stapedotomy surgery. A systematic review and meta-analysis were conducted.

Materials and methods

Publications in English in the last 5 years were searched in the PubMed/MEDLINE database and were systematically reviewed. A total of three articles were included according to the inclusion criteria, obtaining a total of 1531 patients managed surgically for otosclerosis, using laser or drill for footplate fenestration. Data were systematically extracted and hearing results were compared in a meta-analysis.

Results

For the drill group, a total of 978 patients were retrieved and data were obtained as follows: mean age was 50 years old; the female proportion was 62%; mean preoperative air–bone gap (ABG) of 28 dB; mean postoperative ABG of 8 dB; mean ABG improvement of 20 dB; an ABG closure rate to < 10 dB of 74%. For the laser group, a total of 553 patients were retrieved, data were obtained as follows: mean age was 47 years old; the female proportion was 63%; preoperative ABG of 26 dB; postoperative ABG of 8 dB; mean ABG improvement of 18 dB; an ABG closure rate to < 10 dB of 72%.

Conclusion

The results from this study reveal that in regard to postoperative hearing results, surgical outcomes are comparable, and there is no statistically significant difference between the utilization of drills and lasers as a surgical instrument for the fenestration of the stapes footplate during stapedotomy surgery.

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The authors certify that they have no affiliations or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Otolaryngology Department, Althaia University Healthcare Network of Manresa, Carrer Alexandre Soler, 1, 3, Manresa, 08243, Barcelona, Spain

    Ricardo Bartel

  2. Otolaryngology Department, Bellvitge University Hospital, Barcelona, Spain

    Gabriel Huguet, Francesc Cruellas, Miriam Hamdan, Xavier Gonzalez-Compta & Enric Cisa

  3. Barcelona, Spain

    Ricardo Bartel

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  1. Ricardo Bartel
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  2. Gabriel Huguet
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  3. Francesc Cruellas
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  4. Miriam Hamdan
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Correspondence to Ricardo Bartel.

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Bartel, R., Huguet, G., Cruellas, F. et al. Laser vs drill for footplate fenestration during stapedotomy: a systematic review and meta-analysis of hearing results. Eur Arch Otorhinolaryngol 278, 9–14 (2021). https://doi.org/10.1007/s00405-020-06117-1

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  • DOI: https://doi.org/10.1007/s00405-020-06117-1

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