Comparison of argon and CO2 laser stapedotomy in primary otosclerosis surgery

Purpose: The primary use for the laser in otosclerosis surgery is to create a stapes footplate fenestration that obviates the need for mechanical foot plate removal. Experimental studies that evaluate the potential safety of v isible (argon and potassium-titanyl-phosphate [KTP]) and invisible (CO2) li ght laser systems in stapes surgery report conflicting results. The purpose of this study is to compare the clinical safety and efficacy of the CO2 an d argon laser systems when used for primary laser stapedotomy. Materials and Methods: A retrospective case review of 124 primary laser sta pedotomies using either the argon (n = 59) or CO2 (n = 65) laser was perfor med. Data consisted of pre- and postoperative air and bone conduction audio metry, speech discrimination scores (SDS), intraoperative findings, and pos toperative complications. Between group differences (argon v CO2) were soug ht using standard statistical methodology. Results: The argon and CO2 laser groups were comparable with regards to age , sex, preoperative air-bone gap, and laterality. Mean preoperative air and bone conduction pure-tone average (PTA) and SDS were somewhat higher in th e CO2 laser group (P <.05). Postoperatively, both groups showed similar res ults in mean change in air conduction PTA, air-bone gap, and SDS, as well a s in the frequency of complications. There were no anacoustic ears in eithe r group. Conclusions: The results suggest that the argon and CO2 laser systems are c omparable with regards to safety and efficacy when used by experienced surg eons for stapedotomy. (Am J Otolaryngol 2000;21:227-230. Copyright (C) 2000 by W.B. Saunders Company).