Mid-term evaluation of perioperative i.v. corticosteroid treatment efficacy on overall and audiological outcome following CO2 laser stapedotomy: a retrospective study of 84 cases

Abstract

Purpose Our aim was to determine whether perioperatively administered corticosteroid treatment has any beneficial effect on the outcome of stapes surgery, with special regard to the audiological results and early postoperative morbidity. Methods 84 CO 2 laser stapedotomies performed in our institute between 2013 and 2018 were included in our investigation. All cases underwent preoperative and mid-term postoperative pure-tone audiometric evaluation. Vestibular complications were also evaluated. The cases were subdivided into two groups, 23 patients received perioperative i.v. methylprednisolone treatment ("S") while the other 61 patients ("nS") did not receive any adjuvant pharmacological therapy. The data were analyzed retrospectively using IBM SPSS Statistics. Results CO 2 laser stapedotomy proved to be a successful intervention with a significant improvement in ABG and AC thresholds as well. Long-term BC levels were significantly better compared to preoperative ones in the S group; however, in the nS group, no difference could be shown. Hearing and ABG gain were significantly superior in group S [28.1 dB (SD11.2) vs. 18.1 dB (SD 10.9) and 23.9 dB(SD 9.8) vs. 17.2 dB (SD 9.5), respectively]. Conclusion No significant inner ear damage was detectable in the results of our CO 2 laser stapedotomy method; however, the positive effect of corticosteroid treatment could be demonstrated through the postoperative hearing levels. We found no statistical difference in early postoperative morbidity. According to our data, the routine administration of corticosteroids during stapes surgery could be an issue worthy of consideration. The effects of perioperative treatment vs that on the first day after surgery, and topical vs. systemic treatment could be the subject of further investigation in a prospective manner.

Post‐stapedotomy dizziness after applying topical steroid on footplate: A randomized controlled trial

“…Additionally, vestibular complications, hospital days, and inner ear damage were similar between the two groups. 24 On the contrary, in our study, patients receiving topical dexamethasone during the stapedotomy had a significantly shorter hospital stay compared to placebo group. A shorter hospital stay reduces the total cost and might also alleviate hospitalization complications.…”

Revision Stapedotomies: The Role of Periprosthetic Scar Tissue Formation in the Development of Unsatisfactory Hearing Results after Stapedotomy

“… 16 Our group was the first to describe that the above-mentioned adjuvant treatment contributes to a significantly better ABG closure after primary CO 2 laser stapedotomy compared with the control group. 17 Our assumption is that this contribution is manifested through the prevention of scar tissue formation.…”

Otosclerosis: Experience With Stapes Surgery

“…Szekely et al have reported the efficacy of perioperative use of intravenous corticosteroid treatment. The authors concluded that it could be a subject of further investigation in a prospective manner [20]. None of the patients in the current study had such complications.…”