Post Stapedotomy Vestibular Deficit: Is CO2 Laser Better than Conventional Technique? A Non-randomized Controlled Trial.
Identifieur interne : 000380 ( Main/Exploration ); précédent : 000379; suivant : 000381Post Stapedotomy Vestibular Deficit: Is CO2 Laser Better than Conventional Technique? A Non-randomized Controlled Trial.
Auteurs : Anubhav Singh [Inde] ; Rakesh Datta [Inde] ; B K Prasad [Inde] ; Ajith Nilakantan [Inde] ; Renu Rajguru [Inde] ; Manoj Kumar Kanzhuly [Inde] ; Salil Kumar Gupta [Inde] ; Inderdeep Singh [Inde]Source :
- Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India [ 2231-3796 ] ; 2018.
Abstract
The current standard of care for surgical management of Otosclerosis is small fenestra stapedotomy, which can be done by CO2 Laser assisted as well as conventional techniques. Vertigo is the commonest complication after stapes surgery. The use of CO2 Laser has been rising recently owing to its no touch principle, high precision and possibly lower risk of vertigo post operatively. To compare the post-operative vestibular deficit in patients of Otosclerosis having undergone small fenestra stapedotomy by conventional versus CO2 Laser assisted technique. 80 clinically diagnosed Otosclerosis patients fulfilling the inclusion criteria were enrolled. They underwent small fenestra stapedotomy by either conventional or CO2 Laser assisted technique. Vestibular function was assessed objectively by measuring sway velocity using modified clinical test of sensory interaction on balance by static posturography. Subjective measurement of balance was done using Vestibular balance subscore of Vertigo Symptom Score (VSS-sf-V). The outcome measures were compared pre-operatively and at first and fourth week post-operatively. All patients had vestibular deficit 1 week post-operatively in the form of increased sway velocity and symptom scores, which reduced by 4 weeks after Stapedotomy. The vestibular deficit in the two groups was similar at 1 week after surgery. 4 weeks after surgery, the sway velocity in conventional group was significantly greater than Laser group though there was no significant difference in the symptom scores. The use of CO2 Laser for Stapedotomy results in lesser post-operative vestibular deficit as compared to conventional method.
DOI: 10.1007/s12070-018-1298-3
PubMed: 29977860
PubMed Central: PMC6015571
Affiliations:
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A Non-randomized Controlled Trial.</title><author><name sortKey="Singh, Anubhav" sort="Singh, Anubhav" uniqKey="Singh A" first="Anubhav" last="Singh">Anubhav Singh</name><affiliation wicri:level="1"><nlm:affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune</wicri:regionArea><wicri:noRegion>Pune</wicri:noRegion></affiliation></author><author><name sortKey="Datta, Rakesh" sort="Datta, Rakesh" uniqKey="Datta R" first="Rakesh" last="Datta">Rakesh Datta</name><affiliation wicri:level="1"><nlm:affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune</wicri:regionArea><wicri:noRegion>Pune</wicri:noRegion></affiliation></author><author><name sortKey="Prasad, B K" sort="Prasad, B K" uniqKey="Prasad B" first="B K" last="Prasad">B K Prasad</name><affiliation wicri:level="1"><nlm:affiliation>2Department of ORL-HNS, Command Hospital (CC), Lucknow, 226002 India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>2Department of ORL-HNS, Command Hospital (CC), Lucknow</wicri:regionArea><wicri:noRegion>Lucknow</wicri:noRegion></affiliation></author><author><name sortKey="Nilakantan, Ajith" sort="Nilakantan, Ajith" uniqKey="Nilakantan A" first="Ajith" last="Nilakantan">Ajith Nilakantan</name><affiliation wicri:level="1"><nlm:affiliation>167 Military Hospital, c/o 56 APO, Pathankot, India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>167 Military Hospital, c/o 56 APO, Pathankot</wicri:regionArea><wicri:noRegion>Pathankot</wicri:noRegion></affiliation></author><author><name sortKey="Rajguru, Renu" sort="Rajguru, Renu" uniqKey="Rajguru R" first="Renu" last="Rajguru">Renu Rajguru</name><affiliation wicri:level="1"><nlm:affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune</wicri:regionArea><wicri:noRegion>Pune</wicri:noRegion></affiliation></author><author><name sortKey="Kanzhuly, Manoj Kumar" sort="Kanzhuly, Manoj Kumar" uniqKey="Kanzhuly M" first="Manoj Kumar" last="Kanzhuly">Manoj Kumar Kanzhuly</name><affiliation wicri:level="1"><nlm:affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune</wicri:regionArea><wicri:noRegion>Pune</wicri:noRegion></affiliation></author><author><name sortKey="Gupta, Salil Kumar" sort="Gupta, Salil Kumar" uniqKey="Gupta S" first="Salil Kumar" last="Gupta">Salil Kumar Gupta</name><affiliation wicri:level="1"><nlm:affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune</wicri:regionArea><wicri:noRegion>Pune</wicri:noRegion></affiliation></author><author><name sortKey="Singh, Inderdeep" sort="Singh, Inderdeep" uniqKey="Singh I" first="Inderdeep" last="Singh">Inderdeep Singh</name><affiliation wicri:level="1"><nlm:affiliation>4Department of ORL-HNS, INHS Asvini, Mumbai, 400005 India.</nlm:affiliation><country xml:lang="fr">Inde</country><wicri:regionArea>4Department of ORL-HNS, INHS Asvini, Mumbai</wicri:regionArea><wicri:noRegion>Mumbai</wicri:noRegion></affiliation></author></analytic><series><title level="j">Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India</title><idno type="ISSN">2231-3796</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The current standard of care for surgical management of Otosclerosis is small fenestra stapedotomy, which can be done by CO<sub>2</sub> Laser assisted as well as conventional techniques. Vertigo is the commonest complication after stapes surgery. The use of CO<sub>2</sub> Laser has been rising recently owing to its no touch principle, high precision and possibly lower risk of vertigo post operatively. To compare the post-operative vestibular deficit in patients of Otosclerosis having undergone small fenestra stapedotomy by conventional versus CO<sub>2</sub> Laser assisted technique. 80 clinically diagnosed Otosclerosis patients fulfilling the inclusion criteria were enrolled. They underwent small fenestra stapedotomy by either conventional or CO<sub>2</sub> Laser assisted technique. Vestibular function was assessed objectively by measuring sway velocity using modified clinical test of sensory interaction on balance by static posturography. Subjective measurement of balance was done using Vestibular balance subscore of Vertigo Symptom Score (VSS-sf-V). The outcome measures were compared pre-operatively and at first and fourth week post-operatively. All patients had vestibular deficit 1 week post-operatively in the form of increased sway velocity and symptom scores, which reduced by 4 weeks after Stapedotomy. The vestibular deficit in the two groups was similar at 1 week after surgery. 4 weeks after surgery, the sway velocity in conventional group was significantly greater than Laser group though there was no significant difference in the symptom scores. The use of CO<sub>2</sub> Laser for Stapedotomy results in lesser post-operative vestibular deficit as compared to conventional method.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">29977860</PMID><DateRevised><Year>2020</Year><Month>10</Month><Day>01</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">2231-3796</ISSN><JournalIssue CitedMedium="Print"><Volume>70</Volume><Issue>2</Issue><PubDate><Year>2018</Year><Month>Jun</Month></PubDate></JournalIssue><Title>Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India</Title><ISOAbbreviation>Indian J Otolaryngol Head Neck Surg</ISOAbbreviation></Journal><ArticleTitle>Post Stapedotomy Vestibular Deficit: Is CO<sub>2</sub> Laser Better than Conventional Technique? A Non-randomized Controlled Trial.</ArticleTitle><Pagination><MedlinePgn>306-312</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s12070-018-1298-3</ELocationID><Abstract><AbstractText>The current standard of care for surgical management of Otosclerosis is small fenestra stapedotomy, which can be done by CO<sub>2</sub> Laser assisted as well as conventional techniques. Vertigo is the commonest complication after stapes surgery. The use of CO<sub>2</sub> Laser has been rising recently owing to its no touch principle, high precision and possibly lower risk of vertigo post operatively. To compare the post-operative vestibular deficit in patients of Otosclerosis having undergone small fenestra stapedotomy by conventional versus CO<sub>2</sub> Laser assisted technique. 80 clinically diagnosed Otosclerosis patients fulfilling the inclusion criteria were enrolled. They underwent small fenestra stapedotomy by either conventional or CO<sub>2</sub> Laser assisted technique. Vestibular function was assessed objectively by measuring sway velocity using modified clinical test of sensory interaction on balance by static posturography. Subjective measurement of balance was done using Vestibular balance subscore of Vertigo Symptom Score (VSS-sf-V). The outcome measures were compared pre-operatively and at first and fourth week post-operatively. All patients had vestibular deficit 1 week post-operatively in the form of increased sway velocity and symptom scores, which reduced by 4 weeks after Stapedotomy. The vestibular deficit in the two groups was similar at 1 week after surgery. 4 weeks after surgery, the sway velocity in conventional group was significantly greater than Laser group though there was no significant difference in the symptom scores. The use of CO<sub>2</sub> Laser for Stapedotomy results in lesser post-operative vestibular deficit as compared to conventional method.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Singh</LastName><ForeName>Anubhav</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0001-9179-9628</Identifier><AffiliationInfo><Affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</Affiliation><Identifier Source="ISNI">0000 0004 1766 9851</Identifier><Identifier Source="GRID">grid.413909.6</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Datta</LastName><ForeName>Rakesh</ForeName><Initials>R</Initials><Identifier Source="ORCID">0000-0002-5695-3017</Identifier><AffiliationInfo><Affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</Affiliation><Identifier Source="ISNI">0000 0004 1766 9851</Identifier><Identifier Source="GRID">grid.413909.6</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Prasad</LastName><ForeName>B K</ForeName><Initials>BK</Initials><AffiliationInfo><Affiliation>2Department of ORL-HNS, Command Hospital (CC), Lucknow, 226002 India.</Affiliation><Identifier Source="GRID">grid.414653.1</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nilakantan</LastName><ForeName>Ajith</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>167 Military Hospital, c/o 56 APO, Pathankot, India.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rajguru</LastName><ForeName>Renu</ForeName><Initials>R</Initials><Identifier Source="ORCID">0000-0003-3814-6577</Identifier><AffiliationInfo><Affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</Affiliation><Identifier Source="ISNI">0000 0004 1766 9851</Identifier><Identifier Source="GRID">grid.413909.6</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kanzhuly</LastName><ForeName>Manoj Kumar</ForeName><Initials>MK</Initials><AffiliationInfo><Affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</Affiliation><Identifier Source="ISNI">0000 0004 1766 9851</Identifier><Identifier Source="GRID">grid.413909.6</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gupta</LastName><ForeName>Salil Kumar</ForeName><Initials>SK</Initials><AffiliationInfo><Affiliation>1Department of ORL-HNS, Armed Forces Medical College, Wanowrie, Pune, 411040 India.</Affiliation><Identifier Source="ISNI">0000 0004 1766 9851</Identifier><Identifier Source="GRID">grid.413909.6</Identifier></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Singh</LastName><ForeName>Inderdeep</ForeName><Initials>I</Initials><Identifier Source="ORCID">0000-0003-2703-9477</Identifier><AffiliationInfo><Affiliation>4Department of ORL-HNS, INHS Asvini, Mumbai, 400005 India.</Affiliation><Identifier Source="ISNI">0000 0004 1807 9423</Identifier><Identifier Source="GRID">grid.464909.6</Identifier></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>03</Month><Day>14</Day></ArticleDate></Article><MedlineJournalInfo><Country>India</Country><MedlineTA>Indian J Otolaryngol Head Neck Surg</MedlineTA><NlmUniqueID>9422551</NlmUniqueID><ISSNLinking>2231-3796</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">CO2 laser</Keyword><Keyword MajorTopicYN="N">Otosclerosis</Keyword><Keyword MajorTopicYN="N">Postural balance</Keyword><Keyword MajorTopicYN="N">Posturography</Keyword><Keyword MajorTopicYN="N">Stapes surgery</Keyword><Keyword MajorTopicYN="N">Vertigo</Keyword></KeywordList><CoiStatement>Compliance with Ethical StandardsThe authors declare that they have no conflict of interests.All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.Written informed consent was obtained from all individual participants included in the study.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>02</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2018</Year><Month>03</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>7</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>7</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>7</Month><Day>7</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29977860</ArticleId><ArticleId IdType="doi">10.1007/s12070-018-1298-3</ArticleId><ArticleId IdType="pii">1298</ArticleId><ArticleId IdType="pmc">PMC6015571</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>Clin Otolaryngol. 2009 Jun;34(3):212-7</Citation><ArticleIdList><ArticleId IdType="pubmed">19531169</ArticleId></ArticleIdList></Reference><Reference><Citation>Otol Neurotol. 2009 Dec;30(8):1111-5</Citation><ArticleIdList><ArticleId IdType="pubmed">19730141</ArticleId></ArticleIdList></Reference><Reference><Citation>Otol Neurotol. 2003 Jul;24(4):567-71</Citation><ArticleIdList><ArticleId IdType="pubmed">12851546</ArticleId></ArticleIdList></Reference><Reference><Citation>Health Qual Life Outcomes. 2015 Jan 22;13:4</Citation><ArticleIdList><ArticleId 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last="Kanzhuly">Manoj Kumar Kanzhuly</name><name sortKey="Nilakantan, Ajith" sort="Nilakantan, Ajith" uniqKey="Nilakantan A" first="Ajith" last="Nilakantan">Ajith Nilakantan</name><name sortKey="Prasad, B K" sort="Prasad, B K" uniqKey="Prasad B" first="B K" last="Prasad">B K Prasad</name><name sortKey="Rajguru, Renu" sort="Rajguru, Renu" uniqKey="Rajguru R" first="Renu" last="Rajguru">Renu Rajguru</name><name sortKey="Singh, Inderdeep" sort="Singh, Inderdeep" uniqKey="Singh I" first="Inderdeep" last="Singh">Inderdeep Singh</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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