Saúl ASTRAY-GÓMEZ, Alexandra CORTÉS-ARCINIEGAS, Abel GUZMÁN-CALVETE, Carlos DE PAULA-VERNETTA
The Journal of International Advanced Otology - 2026;22(5):1-9
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.
