Objective: This study aimed to compare long-term audiological outcomes of diode laser stapedotomy, microdrill stapedotomy and combined potassium titanyl phosphate laser-microdrill stapedotomy, and to identify predictors of surgical success.
Methods: Surgical, audiological and complications data were collected. Surgical success was analysed via the measurement of post-operative air-bone gap, air conduction gain.
Results: A total of 615 patients were included; median follow-up was 16 months (range 1-1319). Overall, the 94.3 per cent achieved surgical success (air-bone gap < 15 dB). Median air-bone gap closure was 5 dB (interquartile range: 2.50-8.12), and median air conduction gain was 27.5dB (interquartile range: 19.37-36.25).Compared across techniques, success rates were similar; however, post-operative air-bone gap was significantly better with laser techniques than with microdrill alone (p = 0.016). Longer prostheses were associated with improved outcomes.
Conclusion: All the examined techniques showed excellent audiological results. Laser use was associated with better post-operative air-bone gap than stapedotomy with microdrill only.
Keywords: laser; otosclerosis; stapedotomy; stapes surgery.