Laser versus non-laser stapedotomy in otosclerosis: a systematic review and meta-analysis.
OBJECTIVE
To compare and evaluate the hearing outcome and complications of otosclerosis treated with the laser or non-laser stapedotomy using meta-analysis.


METHODS
A thorough search for publications and "in-process" articles with English abstract dating from January 1978 to July 2013 was conducted using Pubmed, EBSCO and Web of Science databases, as well as all related papers. The included criteria were otosclerosis as diagnosis, clear description of surgical methods, calibrated stapedotomy and regular collection of functional results. Hearing results and other comparable data (age, preoperative hearing status, and mean length of follow-up) were collected from the articles.


RESULTS
Eleven studies with a total of 1614 subjects were identified to meet our criteria. There was a significant difference in the efficacy of stapedotomy with the laser or non-laser technique; current data showed a combined RR of 1.07 (95% CI: 1.02-1.13, p=0.005). But, the postoperative complication showed no advantage for the laser group, with a combined RR of 0.63 (95% CI: 0.30-1.34, p=0.23). Although there was publication bias in this study (p=0.005), the funnel plot would turn out to be symmetrical after six more studies were added by the trim and fill method.


CONCLUSION
Our overall results suggest that the laser stapedotomy had significantly better hearing results than non-laser stapedotomy. However, current papers on laser and non-laser stapedotomy did not provide enough subjects to make a subgroup analysis of the hearing outcome between different laser groups. More studies reporting different laser techniques are required to provide us with a better understanding of laser stapedotomy.
['Fang|Lian|L|', 'Lin|Hai|H|', 'Zhang|Tian-Yu|TY|', 'Tan|Jun|J|']
D000328:Adult D005069:Evaluation Studies as Topic D005500:Follow-Up Studies D006309:Hearing D006801:Humans D053685:Laser Therapy D016017:Odds Ratio D010040:Otosclerosis D011183:Postoperative Complications D013201:Stapes Surgery D016896:Treatment Outcome
Stapedotomy Otosclerosis Hearing results Stapes surgery