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 footplate removal. Experimental studies that evaluate the potential safety of visible (argon and potassium-titanyl-phosphate [KTP]) and invisible (CO₂) light laser systems in stapes surgery report conflicting results. The purpose of this study is to compare the clinical safety and efficacy of the CO₂ and argon laser systems when used for primary laser stapedotomy. Materials and Methods: A retrospective case review of 124 primary laser stapedotomies using either the argon (n = 59) or CO₂ (n = 65) laser was performed. Data consisted of pre- and postoperative air and bone conduction audiometry, speech discrimination scores (SDS), intraoperative findings, and postoperative complications. Between group differences (argon v CO₂) were sought 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 the CO₂ laser group (P < .05). Postoperatively, both groups showed similar results in mean change in air conduction PTA, air-bone gap, and SDS, as well as in the frequency of complications. There were no anacoustic ears in either group. Conclusions: The results suggest that the argon and CO₂ laser systems are comparable with regards to safety and efficacy when used by experienced surgeons for stapedotomy. Copyright (C) 2000 by W.B. Saunders Company.