Microdrill stapedotomy for otosclerosis with small and large preoperative air-bone gap: a retrospective comparison of results

Canale, Andrea; Albera, Andrea; Macocco, Francesco; Caranzano, Federico; Albera, Roberto

doi:10.1080/00016489.2020.1764618

Cited by 5 publications

(12 citation statements)

References 8 publications

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“…The 6-month F/U showed ABG closure within 10 dB in almost 80% of operated ears. The results of this study are comparable to other similar studies examining the use of stapedotomy in patients with sABG [9, 10, 12, 13]. In most of these studies, the authors are in favor of performing stapes surgery in patients with an sABG.…”

Section: Discussionsupporting

confidence: 84%

“…In most of these studies, the authors are in favor of performing stapes surgery in patients with an sABG. Canale et al [10] and Salmon et al [12] demonstrated that the residual ABG was bigger in the group of patients with a large ABG (≥25 dB) than in those with an sABG (<25 dB). Their data are consistent with the observation reported by Ueda et al [23] who thought that otosclerotic ears with a large ABG probably have sclerotic lesions at sites other than the oval window.…”

Section: Discussionmentioning

confidence: 99%

“…Their data are consistent with the observation reported by Ueda et al [23] who thought that otosclerotic ears with a large ABG probably have sclerotic lesions at sites other than the oval window. Ueda and colleagues concluded that there is no reason to wait for deterioration in hearing before performing stapedotomy because it presents no additional risk of complications or alterations of the inner ear [10, 12]. On the other hand, Alberti et al [11] believe that even though long-term hearing levels will evolve similarly in patients with ≤20 and >20 dB preoperative ABG, the lack of clinical improvement (interpreted as an improvement of ≥10 dB in the postoperative ABG) found in the group with sABG does not favor early surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The debate over the minimum ABG centers on the risk-to-benefit ratio of stapes surgery in patients with small ABG (sABG) [8, 9]. Most surgeons usually prefer to wait for a change of at least 25–40 dB in the ABG before performing surgery [10, 11]. As pointed out by Alberti and colleagues in 2017, performing stapes surgery in patients with an ABG of less than 25 dB, which is considered small [11, 12], remains controversial [11].…”

Section: Introductionmentioning

confidence: 99%

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Audiometric and Self-Reported Outcomes in Patients with Otosclerosis and a Small Air-Bone Gap after Stapes Surgery

Skarżyński

Dziendziel²,

Gos³

et al. 2023

ORL

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Introduction: The main determinant in deciding on stapes surgery in patients with otosclerosis is the degree of hearing loss, specifically the size of the preoperative air-bone gap (ABG). The debate over the minimum ABG centers on the risk-to-benefit ratio of stapes surgery in patients with small ABG (sABG). The aim of this study was to measure the audiological outcomes and self-assessed satisfaction in a group of otosclerosis patients with an sABG who underwent stapedotomy. Methods: There were 83 patients with preoperative sABG ≤25 dB HL (mean of 500, 1,000, 2,000, 4,000 Hz) included in this study. Audiometry was performed before surgery and 6 months and 12–36 months after surgery. Self-reported patient outcomes before and after surgery were collected using questionnaires. Results: At the 6-month follow-up, the ABG was closed within 10 dB in 63 (78.8%) cases. Preoperatively, tinnitus was present in 70% of patients, of which 66% reported that tinnitus was a moderate or severe problem. Postoperatively, 71% of patients experienced a significant reduction in tinnitus severity and 34% of them reported complete disappearance. The self-report outcomes relating to quality of life and hearing reflected a good level of satisfaction in most patients. Conclusion: The possibility of reducing bothersome tinnitus after stapes surgery, and thus improving the patient’s quality of life, should be taken into account when making a decision on stapes surgery in these patients.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Audiometric and Self-Reported Outcomes in Patients with Otosclerosis and a Small Air-Bone Gap after Stapes Surgery

Skarżyński

Dziendziel²,

Gos³

et al. 2023

ORL

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“…Concerning the surgical approach to the stapes, all surgeries were performed by means of a microdrill, which is considered safe and can even be used in patients with a small preoperative ABG without increasing the risk of sensorineural hearing loss due to inner ear damage 23 . Although reverse stapedotomy was proposed by Fisch in 1980 to prevent excessive mobilisation of the platform or fractures during crurotomy and, theoretically, achieve better hearing outcomes 6 , 7 , we found no significant differences in postoperative ABG between conventional and the reverse stapedotomy.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors influencing postoperative air-bone gap in stapes surgery

Albera¹,

Parandero²,

Andriani³

et al. 2022

Acta Otorhinolaryngol Ital

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SUMMARY Objective Otosclerosis is an osteodystrophic disease of the otic capsule, determining conductive or mixed hearing loss, which can be successfully treated with stapedotomy. The aim of the present multicentric retrospective study was to identify prognostic factors related to better auditory outcomes in stapes surgery. Methods 581 patients affected by otosclerosis were submitted to stapedotomy under local anaesthesia in two different hospitals. Both Teflon and titanium prostheses were adopted. Results A statistically significant decrease of postoperative air-conduction thresholds and air–bone gap (ABG) values was seen, whereas the mean bone-conduction threshold did not differ from the preoperative condition. Among the various parameters investigated, the prosthetic material, duration of surgery and intraoperative detection of unexpected anatomical anomalies of the middle ear were found to be related to lower postoperative ABG values. Conclusions All the previously mentioned parameters played a significant role in determining the postoperative auditory outcomes and can therefore be considered prognostic factors for the success of the stapedotomy.

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Stapes Surgery for Patients with Preoperative Small Air Bone Gap

Salmon

Delhez

Camby

et al. 2022

Curr Otorhinolaryngol Rep

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Purpose of ReviewThis review summarized the existing literature on the stapes surgery for patients with a preoperative air bone gap (ABG) under 30 dB. Recent Findings Early surgery for otosclerosis appears to give good results without increasing the risks of complications, but the topic is still controverted. Summary Stapes surgeries for patients with a preoperative ABG lower than the classical 30 dB are more common today and some studies support this change in paradigm. The risk/benefit balance needs to be discussed with the patients.

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Microdrill stapedotomy for otosclerosis with small and large preoperative air-bone gap: a retrospective comparison of results

Cited by 5 publications

References 8 publications

Audiometric and Self-Reported Outcomes in Patients with Otosclerosis and a Small Air-Bone Gap after Stapes Surgery

Audiometric and Self-Reported Outcomes in Patients with Otosclerosis and a Small Air-Bone Gap after Stapes Surgery

Prognostic factors influencing postoperative air-bone gap in stapes surgery

Stapes Surgery for Patients with Preoperative Small Air Bone Gap

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