Do you feel that it is extremely important to use a laser during a stapedectomy to make the hole in the footplate?
Reply ------------------
It is not "extremely" important whether or not one uses a laser to perform a stapedectomy. There are many different variations in technique in the performance of a stapedectomy. In earlier years, stapedectomy typically involved removing most of the footplate prior to placement of a prosthesis. The vast majority of ear surgeons now favor making a hole in the footplate just large enough to accomodate the shaft of the prosthesis, primarily since small fenestration techniques have been generally found to be associated with less morbidity. As a result, small fenestra stapedectomies are now commonly done as outpatients whereas years ago, several days of hospital- ization were required. Although there appears to be a distinct advantage in making a small fenestra, the fenestra can be made with or without a laser. The use of the laser has certainly become very common, but there are many ear surgeons who perform the procedure without a laser with similar efficacy as those who perform the procedure with a laser. It is also notable that different types of lasers have been used to perform stapedectomy including argon, CO2, and KTP lasers. The use of one over the other often comes down to availability, ease of use, as well as individual physician preference, however strong proponents of lasers in general, or proponents arguing for the use of one laser over another, will offer theoretical scientific arguments. In summary, I would consider it more important to know an individual ear surgeon's overall success rate with stapedectomy and that a small fenestra technique is used than it would be to know that he/she uses a laser to perform the procedure.
--
Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
Click here to review
previous Ear, Nose and Throat Clinic consultations