Erbium: yttrium-aluminum-garnet laser stapedotomy--a safe technique

OBJECTIVE: To standardize the technical parameters of the erbium: yttrium-aluminum-garnet (Er:YAG) laser stapedotomy. STUDY DESIGN: Retrospective study of all patients with otosclerosis who underwent stapedotomy from January 2002 to January 2006. SUBJECTS AND METHODS: The charts of 152 consecutive patients who underwent stapedotomy were reviewed. The patients were stratified into two groups, according to the instrument used. Stapedotomies were performed in group A, with the OPMI TwinEr:YAG laser; and in group B with manual microperforators. RESULTS: No statistically significant differences were found over all measured frequencies, between pre- and postoperative bone conduction thresholds, in each group. At the last postoperative follow-up, vertigo and nystagmus were not detected; two patients in group A and one patient in group B showed persistent tinnitus. CONCLUSION: Er:YAG laser stapedotomy is a safe and effective procedure, with no damage of the inner ear when strict adherence to the safety parameters is observed. The Er:YAG laser is definitively suitable for stapes surgery, and represents a useful and safe tool in the armamentarium of otological microsurgery.