Preliminary Outcomes of the 445-nm Blue Light Laser for Stapedotomy.

Objective: To evaluate the efficacy of the 445-nm blue light laser in stapedotomy, compared with the CO2 laser.

Patients: Patients 18 years or older with a history of otosclerosis who underwent stapedotomy with either carbon dioxide (CO2) or blue light (BL) laser from September 2020 to May 2024. Patients who had revision surgery, underwent stapedotomy without the use of CO2 or BL laser, or were without an available preoperative or postoperative audiogram were excluded.

Intervention: Stapedotomy with the 445-nm BL laser.

Main outcome measure: Postoperative improvement in air-bone gap (ABG) on audiogram for patients who underwent stapedotomy with BL laser, as compared with those who underwent stapedotomy with CO2 laser.

Results: Thirty-two patients were included in the final cohort, with 16 patients in the CO2 laser and BL laser groups, respectively. Although there was no significant difference in the postoperative ABG between the CO2 and BL laser groups (9.1 versus 6.5 dB, p = 0.27), there was a difference in the number of footplate fractures between the CO2 and TB laser groups, although this neither was significant (0 versus 3 events, p = 0.23) nor impacted hearing status.

Conclusion: The BL laser offers comparable closure of the ABG in stapes surgery, as well as a similar safety profile, when compared with the CO2 laser.