eISSN: 2084-9842
ISSN: 1643-9279
Postępy w chirurgii głowy i szyi/Advances in Head and Neck Surgery
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2/2011
vol. 10
 
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abstract:

Surgical treatment of otosclerosis in the Poznan

Witold Szyfter
,
Daniela Mielcarek-Kuchta
,
Dorota Miętkiewska-Leszniewska
,
Anna Młodkowska
,
Joanna Łączkowska-Przybylska

(Postępy w Chirurgii Głowy i Szyi 2011; 2: 41–51)
Online publish date: 2011/10/18
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Otosclerosis is a disease of the otic capsule, which is characterized by conductive hearing loss and tinnitus, and untreated leads to deafness. In the Department of Otolaryngology, Head and Neck Surgery of the Medical University of Poznan between January 1985 and December 2010, 1173 operations were performed in the course of otosclerosis. There were 759 stapedotomies (64%), 329 partial platinectomies (29%) and 85% stapedectomies (7%). Women were more frequently affected than men, with a ratio of 3:1. The age ranged between 16 and 71 years. The Er-Yag laser was used in stapes surgery between 2001 and 2008. Five hundred and ninety-seven operations were done using this laser system. However, since July 2009, 75 operations have been carried out with the CO2 laser. Statistical analysis based on Committee on Hearing and Equilibrium guidelines has shown in the Wilcoxon sequence pair test a statistically significant correlation (p < 0.0001) confirming a decrease in the air-bone gap in patients after surgery using both Er-Yag and CO2 lasers. Nevertheless, comparing the hearing threshold levels before and after the surgery for the frequency 3 kHz in the case of the CO2 laser, one can note p value = 0.036386, close to the borderline value 0.05, which may suggest thermal injury while using it. Based on many years of our observations, we believe that stapes surgery is the most effective method in the treatment of patients with hearing loss in the course of otosclerosis. Both lasers are a good alternative to classical surgery. However, the CO2 laser, although far more technologically advanced, poses some risk since it can damage the hearing organ in higher frequencies.
keywords:

otosclerosis, surgical treatment, Er-Yag laser, CO2 laser
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