Stapedotomy: analysis of factors affecting functional prognosis
DOI:
https://doi.org/10.34631/sporl.3070Keywords:
Otosclerosis, Stapedotomy, Stapes surgery, Prosthesis diameter, Functional successAbstract
Objectives: To evaluate the success rate of stapedotomy and investigate the influence of prognostic factors on hearing outcomes.
Materials and Methods: A retrospective study of 157 ears that underwent primary stapedotomy between 2001 and 2022. Patient- and procedure-related factors that influenced postoperative hearing thresholds were analyzed. The diameter of the Teflon prosthesis used (0,4 mm – 68 ears; 0,6 mm – 89 ears) and pre- and postoperative audiometric data were analyzed. Surgical success was defined as a postoperative air-bone gap (ABG) ≤ 10 dB HL.
Results: Surgical success was achieved in 64% of operated ears. Significant improvements in air conduction thresholds and ABG were observed, with an average hearing gain of 18,67 ± 10,8 dB HL. Comparison of the 0,6 mm- and 0,4 mm-groups, revealed no differences (p>0,05) regarding improvements in AC-PTA (21,11 vs. 18,71 dB), BC-PTA (2,40 vs. 0,29 dB) and ABG-PTA (118,71 vs. 18,62 dB). Surgical success was similar between the two types of prostheses, being slightly higher with the larger diameter prosthesis (66,3% vs. 61,8%). Multivariate analysis of prognostic factors identified preoperative ABG (p = 0,042) and patient age (p = 0,045) as independent predictors of less surgical success (95% CI). Variables such as gender, the presence of preoperative tinnitus or vertigo did not independently and significantly influence surgical success (p > 0,05).
Conclusions: Stapedotomy is a procedure with good functional outcomes. Prosthesis diameter does not influence surgical outcomes. Preoperative ABG > 30 dB HL and age < 50 years seem to be factors that influence surgical success. Gender, the presence of preoperative tinnitus or vertigo, do not appear to influence the success of the procedure.
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Dhooge I, Desmedt S, Maly T, Loose D, Van Hoecke H. Long-term hearing results of stapedotomy: analysis of factors affecting outcome. Eur Arch Otorhinolaryngol. 2018 May;275(5):1111-1119. doi: 10.1007/s00405-018-4899-2.
Ealy M, Smith RJH. Otosclerosis. Adv Otorhinolaryngol. 2011:70:122-129. doi: 10.1159/000322488.
Uppal S, Bajaj Y, Rustom I, Coatesworth AP. Otosclerosis 1: the aetiopathogenesis of otosclerosis. Int J Clin Pract. 2009 Oct;63(10):1526-30. doi: 10.1111/j.1742-1241.2009.02045.x
Cureoglu S, Schachern PA, Ferlito A, Rinaldo A, Tsuprun V, Paparella MM. Otosclerosis: etiopathogenesis and histopathology. Am J Otolaryngol. 2006 Sep-Oct;27(5):334-40. doi: 10.1016/j.amjoto.2005.11.001.
Schrauwen I, Van Camp G. The etiology of otosclerosis: a combination of genes and environment. Laryngoscope. 2010 Jun;120(6):1195-202. doi: 10.1002/lary.20934.
Czerwińska G, Ścierski W, Namysłowski G, Lisowska G, Misiołek M. The surgical treatment results of otosclerosis at the Department of Otolaryngology Silesian Medical University in Zabrze in years 2000–2010 Otolaryngol Pol. 2017 Apr 30;71(2):16-21. doi: 10.5604/01.3001.0009.8410.
Khorsandi A. MT, Jalali MM, Shoshi D. V. Predictive factors in 995 stapes surgeries for primary otosclerosis. Laryngoscope. 2018 Oct;128(10):2403-2407. doi: 10.1002/lary.27160.
Laske RD, Röösli C, Chatzimichalis MV, Sim JH, Huber AM. The influence of prosthesis diameter in stapes surgery: a meta-analysis and systematic review of the literature. Otol Neurotol. 2011 Jun;32(4):520-8. doi: 10.1097/MAO.0b013e318216795b.
Marchese MR, Conti G, Cianfrone F, Scorpecci A, Fetoni AR, Paludetti G. Predictive role of audiological and clinical features for functional results after stapedotomy. Audiol Neurootol. 2009;14(5):279-85. doi: 10.1159/000212105.
Fisch U. Stapedotomy versus stapedectomy. 1982. Otol Neurotol. 2009 Dec;30(8):1160-5. doi: 10.1097/MAO.0b013e3181c1792d.
Bailey HAT, Pappas JJ, Graham SS. Small fenestra stapedectomy. A preliminary report. Laryngoscope. 1981 Aug;91(8):1308-21. doi: 10.1288/00005537-198108000-00013.
Vincent R, Sperling NM, Oates J, Jindal M. Surgical findings and long-term hearing results in 3,050 stapedotomies for primary otosclerosis. Otol Neurotol. 2006 Dec;27(8 Suppl 2):S25-47. doi: 10.1097/01.mao.0000235311.80066.df.
Wegner I, Eldaebes MMAS, Landry TG, Grolman W, Bance ML. The effect of piston diameter in stapedotomy for otosclerosis: a temporal bone model. Otol Neurotol. 2016 Dec;37(10):1497-1502. doi: 10.1097/MAO.0000000000001212.
Bittermann AJN, Rovers MM, Tange RA, Vincent R, Dreschler WA, Grolman W. Primary stapes surgery in patients with otosclerosis prediction of postoperative outcome. Arch Otolaryngol Head Neck Surg. 2011 Aug;137(8):780-4. doi: 10.1001/archoto.2011.100.
Strömbäck K, Lundman L, Bjorsne A, Grendin J, Stjernquist-Desatnik A, Dahlin-Redfors Y. Stapes surgery in Sweden: evaluation of a national-based register. Eur Arch Otorhinolaryngol. 2017 Jun;274(6):2421-2427. doi: 10.1007/s00405-017-4510-2.
Wegner I, Verhagen JJ, Stegeman I, Vincent R, Grolman W. A systematic review of the effect of piston diameter in stapes surgery for otosclerosis on hearing results. Laryngoscope. 2016 Jan;126(1):182-90. doi: 10.1002/lary.25408
Committee on hearing and equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. Otolaryngology–Head and Neck Surgery. 1995 Sep;113(3):186–7. DOI: 10.1016/S0194-5998(95)70103-6
Wegner I, van Waes AM, Bittermann AJ, Buitinck SH, Dekker CF, Kurk SA. et al. A Systematic review of the diagnostic value of CT imaging in diagnosing otosclerosis. Otol Neurotol. 2016 Jan;37(1):9-15. doi: 10.1097/MAO.0000000000000924.
Kisilevsky VE, Dutt SN, Bailie N, Halik JJ. Hearing results of 1145 stapedotomies evaluated with Amsterdam hearing evaluation plots. J Laryngol Otol. 2009 Jul;123(7):730-6. doi: 10.1017/S0022215109004745.
Cavaliere M, Ricciardiello F, Mesolella M, Iengo M. Stapedotomy: functional results with different diameter prostheses. ORL J Otorhinolaryngol Relat Spec. 2012;74(2):93-6. doi: 10.1159/000335927.
Shabana, Ghonim, Pedersen. Stapedotomy: does prosthesis diameter affect outcome? Clin Otolaryngol Allied Sci. 1999 Apr;24(2):91-4. doi: 10.1046/j.1365-2273.1999.00207.x.
Bernardeschi D, De Seta D, Canu G, Russo FY, Ferrary E, Lahlou G. et al. Does the diameter of the stapes prosthesis really matter? A prospective clinical study. Laryngoscope. 2018 Aug;128(8):1922-1926. doi: 10.1002/lary.27021.
Sennaroglu L, Ünal ÖF, Sennaroglu G, Gürsel B, Belgin E. Effect of teflon piston diameter on hearing result after stapedotomy. Otolaryngol Head Neck Surg. 2001 Mar;124(3):279-81. doi: 10.1067/mhn.2001.112431.
Grolman W, Tange RA, Bruijn AJ de, Hart AA, Schouwenburg PF. A retrospective study of the hearing results obtained after stapedotomy by the implantation of two Teflon pistons with a different diameter. Eur Arch Otorhinolaryngol. 1997;254(9-10):422-4. doi: 10.1007/BF02439972.
Sim JH, Chatzimichalis M, Röösli C, Laske RD, Huber AM. Objective assessment of stapedotomy surgery from round window motion measurement. Ear Hear. 2012 Sep-Oct;33(5):e24-31. doi: 10.1097/AUD.0b013e318258c7a6.
Dhooge I, Desmedt S, Maly T, Loose D, Van Hoecke H. Long-term hearing results of stapedotomy: analysis of factors affecting outcome. Eur Arch Otorhinolaryngol. 2018 May;275(5):1111-1119. doi: 10.1007/s00405-018-4899-2.
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Copyright (c) 2025 Ana Margarida Araújo Martins, Catarina Pinto, Mariana Santos, Rita Moura, Rui Fonseca
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