Evolution of methods of assistance in stapes surgery in patients with otosclerosis

Introduction. It is not always possible to create a perforation in the footplate of the stirrup with the help of classical microinstruments during stapedoplasty, which will exactly correspond to the required parameters, moreover, these tools can be dangerous in some cases, since it is possible to provoke the footplate to enter the ear labyrinth, mobilizing it.
Aim. To determine the efficacy and safety of various methods of stapes surgery in otosclerosis with an assessment of the frequency of intra- and postoperative complications.
Materials and methods. In the Clinic of Ear, Throat and Nose Diseases of the I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University) a number of experimental and clinical studies were conducted, partial results of which we decided to retrospectively compare and analyze. The data of the first group of patients were taken from the results of a study with a CO₂ laser. The data of the second group of patients were obtained from the results of a study with a diode (blue) laser with a wavelength of 445 nanometers. The data of the third group of patients were collected from archival data of medical histories from 2020 to 2022, who used a set of micro-tools for stapedoplasty (manual micropeforator, microneedle).
Results. The data obtained showed similar results in the CO₂ and blue laser groups. The main difference in the group of patients who underwent stapedoplasty with classical microinstruments was a longer operation time compared to laser stapedotomies, as well as a greater number of intraoperative difficulties associated with the mobilization of the foot plate of the stapes during manipulations with a manual perforator.
Conclusions. The use of blue laser and CO₂ laser in stapedotomy procedures shows promising results in terms of surgical accuracy and speed of the operation. Further research should compare the long-term effects of these three methods to determine the most effective and safest.

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