The authors have studied the use of the CO2 laser in performing primary stapedotomy in 451 patients affected by otosclerosis, operated between 1996 and 2000. Footplate perforation was practised with a traditional method, by means of a microdrill, in 169 subjects. A CO2 laser was instead used in other 282 cases; the authors effected the platinotomy with a single spot, repeated if necessary, with the diameter adjusted to the caliber of the prosthesis. This procedure allowed a smooth-edged perforation to be obtained. In the 282 laser-operated patients, there was a significantly higher proportion having closure of the cochlear reserve within 10 dB than that found in the cases where the microdrill was used. Moreover, no postoperative anacusia or severe vertigo were recorded; this confirms the safety of the CO2 laser as regards the inner ear. The functional results, therefore, document the validity of the exposed technique.

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