Comparison of different oval window sealing materials in stapes surgery: systematic review and meta-analysis

Abstract

Objective To compare the efficacy and safety characteristics of different materials used for oval window sealing during stapedotomy. Methods A systematic review was conducted according to the PRISMA guidelines. Published international English literature from January 1, 2000 to December 2021 was screened, checking for studies that compared different materials utilization in patients undergoing stapedotomy surgery for otosclerosis or congenital stapes fixation. Data related to the efficacy and safety of each material were extracted. The primary outcome measure was the air–bone gap (ABG) closure after surgical intervention. Results Six studies were included in the metanalysis. Because of the heterogeneity of the treatments adopted, we assessed the use of the fat compared to all other treatments, and the use of the gelfoam compared to all other treatments. In the former analysis (fat vs others) we did not identify differences in ABG closure between the groups (p = 0.74), with a low heterogeneity of the results (I2 = 28.36%; Hedge’s g = 0.04, 95% CI − 0.19 0.27); similarly, we did not identify differences between the use of gelfoam and other treatments (p = 0.97), with a low heterogeneity of the results (I2 = 28.91%; Hedge’s g = 0.00, 95% CI − 0.20 0.21). Conclusions Numerous options are available for oval window sealing during stapedotomy, with acceptable safety and effectiveness profiles. Based on the current data, no definitive recommendation can be made regarding the choice of one material over another, and the convenience of sealing over no sealing at all.

Adenoid cystic carcinoma of the parotid and submandibular glands in children and young adults: A population‐based study

“…Adults are subject to cofactors like aging, lifestyle, and environmental influences, which can influence survival rates. Nonetheless, even within the adult population, the role of aRT remains a subject of debate 44 …”

Effect of closing material on hearing rehabilitation in stapedectomy and stapedotomy: A finite element analysis

“…On the other hand, only few references state that the stapedectomy allows better hearing rehabilitation ( Persson et al, 2009 ); according to them, hearing levels of patients who underwent total stapedectomy recovered by about 7 dB more after 1 year of follow up and by 6 dB more after 3 years of follow up in a pure tone average (PTA) than those of patients who underwent the stapedotomy. A few other studies have noted that there were no substantial differences between both surgical techniques and that both have been reported to yield similar clinical outcomes ( Cremers et al, 1991 ; Sedwick et al, 1997 ; Quaranta et al, 2005 ; Vasama et al, 2006 ; Scarpa et al, 2022 ). Based on these observations, it has been generally accepted that the stapedotomy is safer and more effective for helping patients with otosclerosis than the stapedectomy ( Bailey et al, 1981 ; Pedersen and Elbrønd, 1983 ; Moon and Hahn, 1984 ; House et al, 2002 ; Colletti and Fiorino, 2016 ; Somers et al, 2016 ).…”