DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20205617

Partial stapedectomy versus stapedotomy: evaluation of functional outcomes

Amine En-nouali, Abdelfattah Aljalil, Mohammed A. Hanine, Youssef Darouassi Darouassi, Haddou Ammar

Abstract


Background: Surgery is the treatment of choice for otosclerosis, its technical aspects are codified but varied and its functional results are usually excellent. The aim of this study was to compare the audiometric results obtained after partial stapedectomy and stapedotomy.

Methods: A retrospective review of records of patients who underwent stapes surgery for otosclerosis at Avicenna Military Hospital in Marrakesh (Morocco) from January 2008 to December 2018 was conducted.  

Results: Air conduction thresholds before (53.3±9.8 dB) and after (25.1±6.5) partial stapedectomy was statistically significant (p<0.05) and with stapedotomy before (56.4±7.2) and after (33.1±9.5) surgery also statistically significant (p<0.05). However, air conduction thresholds between the two groups was not statistically significant (p=0.592). Preoperative air-bone gap (ABG) in partial stapedectomy cases was 28.7±8.6 dB and postoperative ABG was 5.7 ± 2.6 dB (p<0.05). Preoperative ABG in patients who underwent stapedotomy was 31.2±6.4 dB and postoperative ABG was 7.5±5.2 dB (p<0.05). ABG improvement in each group was statistically significant, but between the two groups it was not statistically significant (p=0.434). A greater ABG closure rate was observed after partial stapedectomy (81.4%) than after stapedotomy (74.4%), but the difference was not statistically significant (p=0.236).

Conclusions: We can conclude that both techniques are effective and safe and that the decision of which technique to perform should depend on the experience and comfort level of the surgeon with either technique.

 


Keywords


Air conduction, Air-bone gap, Otosclerosis, Partial stapedectomy, Stapedotomy

Full Text:

PDF

References


Chole RA, Kenna M. Pathophysiology of otosclerosis. Otol Neurotol. 2001;22:249-57.

Guan JGC, Beng YS. A retrospective study: good functional outcomes are independent of pre-operative factors in stapes surgery for otosclerosis. Research J Ear Nose Throat. 2018;2(1):2.

Glasscock ME, Storper IS, Haynes DS, Bohrer PS. Twenty-five years of experience with stapedectomy. Laryngoscope. 1995;105;(9):899-904.

Gilli RE, Grayeli BA, Boutin P. Otosclerosis surgical techniques and results in 150 patients. Ann Otolaryngol Chir Cervicofac. 2002;119(4):227-33.

Redfors D, Möller. Follow-up after surgery for otoselerosis. Annals Otology Rhinol Laryngol. 2011;20(9):608-14.

House HP, Hansen MR, Aziz A. Al Dakhail, John W. Stapedectomy versus stapedotomy. Laryngoscope. 2002;112:22-4.

Monsell EM, Balkany TA, Gates GA, Goldenberg RA, Meyerhoff WI, House JW. Committee on hearing and equilibrium guidelines for evaluation of results of treatment of conductive hearing loss. Otolaryngol Head Neck Surg. 1995;113(3):186-7.

Balu R, Kumar M, Nair PG. Small fenestra stapedotomy versus large fenestra stapedectomy in improving hearing ability in patients with otosclerosis: our 10 years experience. Indian J Otolaryngol Head Neck Surg. 2019;71:304-8.

Quaranta N, Besozzi G, Fallacara RA, Quaranta A. Air and bone conduction change after stapedotomy and partial stapedectomy for otosclerosis. Otolaryngol Head Neck Surg. 2005;133:116-20.

Cremers CW, Beusen JM, Huygen PL. Hearing gain after stapedotomy, partial stapedectomy, or total stapedectomy for otosclerosis. Ann Otol Rhinol Laryngol. 1991;100:959-61.

Persson P, Harder H, Magnuson B. Hearing results in otosclerosis surgery after partial stapedectomy, total stapedectomy and stapedotomy. Acta Otolaryngol. 1997;117:94-9.

Langman AW, Jackler RK, Sooy FA. Stapedectomy: long-term hearing results. Laryngoscope. 1991;101:810-4.

Berliner KI, Doyle KJ, Goldenberg RA. Reporting operative hearing results in stapes surgery: does choice of outcome measure make a difference? Am J Otol. 1996;17:521-8.

Dornhoffer JL, Bailey HAJ, Graham SS. Long-term hearing results following stapedotomy. Am J Otol. 1994;15:674-8.

Carhart R. Clinical application of bone conduction audiometry. Arch Otolaryngol. 1950;51:798-808.

Tonndorf J. Bone conduction hearing. In: Keidel WD, Neff WD, eds. Handbook of sensory physiology. Berlin: Springer; 1994.

Sedwick JD, Louden CL, Shelton C. Stapedectomy vs stapedotomy. Do you really need a laser?. Arch Otolaryngol Head Neck Surg. 1997;123:177-80.

Kursten R, Schneider B, Zrunek M. Long-term results after stapedectomy versus stapedotomy. Am J Otol. 1994;15:804-6.