Statistical Analysis of Otosclerosis Surgery Performed by Jean Marquet

Abstract

The early and long-term hearing results of 1,681 primary otosclerosis operations performed by the same surgeon, Jean Marquet, were reviewed retrospectively and analyzed with very strict statistical standards. Significantly better short- and long-term results were achieved with the stapedotomy technique compared to total stapedectomy, mainly at the higher frequencies (4 and 8 kHz) important for speech discrimination. Whatever technique was used to open the footplate (micropick, microdrill, or laser), no statistical audiometric difference could be found. The results were equal whether or not the stapedial tendon was preserved. Perioperative problems like pronounced oozing, difficult anatomic relationships, and accidental perilymph aspiration could affect hearing at higher frequencies. The calibrated hole technique was equally as good as conventional oval window sealing in sealing of the fenestra to prevent fistula. The stapedotomy technique was found the safest, having fewer complications.

CO2 Laser-Assisted Stapedotomy Combined With àWengen Titanium Clip Stapes Prosthesis

“…Considering the number of patients, our results are statistically significantly better than those reported by Grolman and Tange (22) and Fisch (31). Table 2 shows the average functional gain (33) was not statistically significant, while the gain obtained by Somers et al (35) was statistically significantly better than ours ( p G 0.05). Even when we changed the assumed SD to 12.7 or 11.6 dB, these conclusions did not change.…”

Audiometric Results after Stapedotomy Operations in Patients with Otosclerosis and Preoperative Small Air-Bone Gaps

“…With the evolution of stapes surgical techniques from the use of microinstruments for stapedectomies to the use of a microdrill and the use of lasers for stapedotomy, the risk of mechanical trauma is lower and the indications increasing. Since the early 1970s, the small-fenestra stapedotomy technique has become a standard because the procedure is less traumatic, reduces the risk of SNHL and provides better high-frequency gain [Fisch, 1982;Moon and Hahn, 1984;House, 1993;Somers et al, 1994]. The minimum ABG seen as an indication for footplate surgery varies among authors; it has been reported within the range of 35-40 dB [Glasscock and Shambaugh, 1990] and 25 dB or greater [Wiet et al, 1986].…”

Evaluation of Second-Ear Stapedotomy with the Glasgow Benefit Plot

“…The patient who has had a successful stapes surgery with hearing improvement on one side will often ask the surgeon to perform an operation in the second ear. The low risk of delayed sensorineural hearing loss after stapedotomy appears to support the policy of performing a second-ear operation for optimum auditory rehabilitation [7][8][9][10].…”