Argon laser assisted small fenestra stapedotomy for otosclerosis

To report and analyse our results and complications of argon laser assisted stapedotomy for primary otosclerosis. A retrospective analysis of 135 consecutive cases of primary otosclerosis operated by the senior author (JH) has been performed. The air–bone gap was calculated by using the pure tone average at 500, 1000, 2000 and 4000 Hz. A separate analysis of air–bone gap at 500, 1000 and 2000 Hz was carried out to assess the effects of a small diameter piston on low frequency hearing. Hearing at high frequencies (4000 and 8000 Hz) was also assessed to evaluate effects of small fenestra technique on high frequency hearing. Preservation of cochlear function was assessed by comparing the average pre- and post-operative bone conduction thresholds. Complications arising were analysed. The post-operative air–bone gap at 0.5, 1 and 2 kHz was 10 dB or less in 85.19% of patients and 20 dB or less in 97.04% patients. The air–bone gap at 0.5–4 kHz was ≤10 dB in 77.04% of patients and 20 dB or less in 97.04% patients. The majority of patients showed an improvement at 4 kHz (81.4%) and 8 kHz (60.7%). There was no change in the average pre- and post-operative bone conduction thresholds. There were no major complications. Argon laser reduces mechanical trauma to the vestibule and increases precision resulting in consistent hearing results in all frequencies and reduced post-operative morbidity.