Factors Affecting the Outcome of Stapes Surgery

Abstract

To study the outcome of stapes surgery based on the Clinical, Audiometry, and Surgical pre- and postoperative factors. This study is a prospective study of factors affecting the outcome of stapes surgery in otosclerosis patients. From February 2010 to June 2011, 57 patients of confirmed clinical otosclerosis were analysed. Out of them, 31 patients were included in our study as were available for follow-up. Clinical, audiometry and surgery-related parameters were included to assess the surgery outcome. Results were reported as suggested by AAO-HNS (American Association of Otolaryngology and Head and Neck Surgery) guidelines for stapes surgery, 1995. The paired t-test and analysis of variables test (ANOVA) were used to evaluate the results. A value of<0.05 was considered significant. There was statistically significant improvement in ABG (air bone gap) closure at 3 months of surgery ( value <0.001). Among all cases, PTA BC (pure tone average bone conduction) at 3 months of surgery was found in the range of 7.5 dB to 43.75 dB. ABG closure was achieved in the range of 0 dB to 27.5 dB among all cases. Variables like gender, degree of hearing loss, type of footplate, sealing material, and piston diameter were definitely predicting the outcome of stapes surgery. Pure tone audiometry plays an important role to diagnose the otosclerosis, to evaluate degree and type of hearing loss and to assess hearing outcome after surgery. Our results may improve knowledge of predictive factors, providing the surgeon with useful information to plan surgery with a better case selection as well as to counsel the patient on the likelihood of success of the procedure.

Predictive factors in 995 stapes surgeries for primary otosclerosis

“…In our study, 93.6% of the patients had ABG closure 10 dB in primary surgery. According to previous research, 7,9,[14][15][16] an ABG 10 dB was seen in 62% to 94% of the patients. Differences in the number of studied patients, the applied surgical technique (e.g., stapedotomy, reverse stapedotomy, stapedectomy, and laser-assisted procedures) and the surgeon's experience 17 noticed the existence of a learning curve in stapes surgery.…”

“…In our study, 2.6% of the cases had obliterative footplate. Shah and Ganapathy and Hausler reported the condition to have an incidence rate of 3% to 10%. Similar to previous studies, we found significantly worse ABG closure in patients with obliterative footplate.…”

“…Shah and Ganapathy and Hausler reported the condition to have an incidence rate of 3% to 10%. Similar to previous studies, we found significantly worse ABG closure in patients with obliterative footplate. Furthermore, our study suggested bilateral otosclerosis as a significant predictor of excellent outcome (OR = 2.09).…”

“…It is a fact that the surgical procedure and intraoperative findings may affect the outcome of stapedotomy . Nevertheless, only a few reports have investigated the effects of preoperative variables on the postoperative hearing gain. Therefore, direct comparison with previous studies is difficult due to differences in reporting methods, surgical techniques, and piston and grafting materials.…”

Stapedotomy using skeeter drill and self-retaining ear canal retractor: a single surgeon's 1000-plus surgical procedure experience

“…Theoretically, the use of connective tissue seal may prevent perilymph leakage and restore the stiffness of the annular ligament. In this study, soft tissue from postauricular sulcus was used, whereas Shah et al 31 used absorbable gelatin sponge or fat as a sealing material.…”