Prospective clinical study on cochlear function after erbium:yttrium-aluminum-garnet laser stapedotomy

Objective: To assess whether the application of the emitting erbium:yttrium-aluminum-garnet (Er: YAG) laser in stapedotomy has negative effects on vestibular and cochlear functions. Design: Prospective, with 12 to 14 months follow-up. Setting. Academic tertiary referral center. Patients. Twenty-four patients undergoing stapedotomy (primary surgery) in otosclerosis. Intervention: All patients underwent Er:YAG laser-assisted stapedotomy for otosclerosis between January 2000 and June 2002. Main Outcome Measures: Early (1-3 days after surgery) and late (12-14 months after surgery) postoperative bone-conduction thresholds and the presence of postoperative tinnitus and vertigo were analyzed. In addition, the relation between applied laser energy and postoperative bone-conduction thresholds was calculated. Results: In 22 patients, unchanged preoperative minus early postoperative pure-tone bone-conduction averages at 1, 2, and 4 kHz were observed. In one patient, a slight early deterioration between 10 and 20 dB was seen. In 18 patients, unchanged preoperative minus late postoperative pure-tone bone-conduction averages at 1, 2, and 4 kHz were observed. In two patients, a slight late deterioration between 10 and 20 dB was seen. In two patients, a new postoperative tinnitus was observed. No patient suffered from vertigo at the time of second evaluation. No correlation between applied laser energy and both postoperative bone-conduction thresholds was found. Conclusions: The Er:YAG laser stapedotomy in otosclerosis is a safe technique. Vestibular and cochlear function is not significantly disturbed after Er:YAG laser stapedotomy.