Показания и эффективность вариантов ассистенции при стапедопластике у больных отосклерозом

Abstract

The present-day Russian literature on stapes surgery has no sufficient information about the efficacy and safety of using the assistance facilities such as microdrills and laser systems, as well as their advantages and drawbacks and the criteria of their rational choice. The objective of the study is to assess the indications, safety, and efficacy of the use of CO2 laser and micro drill at the stage of stapedotomy in the patients with otosclerosis. Based on the analysis of the results of examination and surgical treatment of 100 patients with various forms of otosclerosis, who underwent a piston stapoplasty (50 patients) and a method of installation of metallized stapes prosthesis on an autovenous graft (50 patients) using a CO2-laser system (n = 50) and micro drill (n = 50), the article presents the data on their safe use and efficacy, as well as the criteria of selection of the assistance facilities. It has been revealed that the choice of stapedoplasty method is affected by the use of temporal bones in the CT diagnostics, the expansion of otosclerosis foci, the anatomical structure of the oval window niche and the specific features of the surgery. The authors pointed out the advantage of efficacy of the method of installation of stapes prosthesis on an autovenous graft after extensive stapedotomy, regardless the assistance facilities.