FIBEROPTIC ARGON-LASER STAPEDOTOMY - IS IT SAFE

The history of otosclerosis surgery has been marked by major advances in both surgical technique and instrumentation. Fenestration, stapes m obilization, total stapedectomy, and stapedotomy were important advanc es in technique. Loupes, binocular microscopy, speculum holders, and m icrodrills similarly advanced instrumentation. What about fiberoptic a rgon laser handpieces for use in laser stapedotomy? Do they represent a significant advance in instrumentation, or are they merely another g immick? Are fiberoptic argon laser handpieces safe? Experimentally, th e thermal effects of argon laser, delivered via fiberoptic handpieces to a cadaver stapes and model vestibule, were studied. No significant temperature elevations within a model vestibule were observed during s tapedotomy. There were significant temperature elevations within the l aser plume at the level of the facial nerve. These findings are consis tent with our experience in over 2200 primary and revision stapedotomi es. To date, there have been no cases of significant hearing loss or p ermanent facial paralysis related to the use of these fiberoptic handp ieces. We believe fiberoptic argon laser handpieces are as safe as con ventional microsurgical instruments in stapes surgery.