A meta-analysis review of revision stapes surgery with argon laser: effectiveness and safety.
OBJECTIVE: To determine whether there is an advantage in safety and outcome efficacy with the use of argon laser in revision stapes surgery as compared with conventional instruments.
DATA SOURCES: A search of the published English-language literature, 1970-1995, was conducted using the following key words: revision, surgery, stapes, laser, stapedotomy, and argon laser.
STUDY SELECTION: The following inclusion criteria were used to select articles for the meta-analysis: revision cases only, a comprehensive review of intraoperative pathological findings that led to the failure, and accurate documentation by the author, confirmed by our statisticians using a modified chi 2 test. Eleven studies without the use of the laser (n = 1,147 patients) and four studies with the use of the laser (n = 170 patients) including our own patients (n = 23) were entered into the model.
DATA EXTRACTION: The data had to meet strict audiometric criteria, including preoperative and postoperative audiogram pure tone average air-bone gap; postoperative audiograms had to include five classifications, and these audiograms had to be obtained a minimum of 6 months after revision surgery.
DATA SYNTHESIS: A log-linear model was developed for this meta-analysis study, with each study analyzed individually and collectively.
CONCLUSION: Revision stapes surgery using the laser demonstrated statistically significant (p = 0.002) advantage in both safety and efficacy over revision procedures using conventional instruments.
Published In/Presented At
Wiet, R. J., Kubek, D. C., Lemberg, P., & Byskosh, A. T. (1997). A meta-analysis review of revision stapes surgery with argon laser: effectiveness and safety. The American journal of otology, 18(2), 166–171.
Medicine and Health Sciences
Department of Surgery, Division of Otolaryngology