蓝激光在耳科手术中的当前作用：一项叙述性综述。

文献信息

中文摘要

背景： 蓝激光技术，特别是445-450 nm波长的蓝色二极管激光，凭借其独特的光血管作用和止血特性，代表了耳科手术中的一项新兴创新。方法：本叙述性综述讨论了直接针对445-450 nm蓝色二极管激光的耳科研究证据，以评估蓝激光系统在耳部手术中的临床应用、结局和安全性特征。结果：该技术已在耳硬化症的镫骨切开术、中耳副神经节瘤切除和胆脂瘤手术中得到探索。初步且仍然有限的临床数据提示，听力学结局与传统的二氧化碳激光系统大致相当，并提出了在止血和热效应方面的潜在优势。直接的耳科证据仍局限于少量病例系列和回顾性比较，大多数出版物出现于2018年至2025年间。结论：本综述将蓝激光技术确定为耳科外科医生武器库中一种有前景的辅助手段，值得开展更大规模的随机对照试验，以建立明确的临床指南和长期安全性特征。

英文摘要

Blue laser technology, specifically the 445-450 nm wavelength blue diode laser, represents an emerging innovation in otologic surgery with unique photoangiolytic and hemostatic properties. This narrative review discusses evidence from otologic studies directly addressing the 445-450 nm blue diode laser to evaluate the clinical applications, outcomes, and safety profile of blue laser systems in ear surgery. The technology has been explored in stapedotomy procedures for otosclerosis, middle ear paraganglioma excision, and cholesteatoma surgery. Preliminary and still limited clinical data suggest audiological outcomes broadly comparable to traditional carbon dioxide laser systems, with a proposed advantage in hemostasis and thermal. Direct otologic evidence remains limited to a small number of case series and retrospective comparisons, with most publications emerging between 2018 and 2025. This review identifies blue laser technology as a promising adjunct to the otologic surgeon's armamentarium, warranting larger randomized controlled trials to establish definitive clinical guidelines and long-term safety profiles.