Cochlear Implantation or Stapes Surgery in Far Advanced Otosclerosis

Abstract

Abstract Background Otosclerosis is a process of bone resorption of the labyrinthine capsule followed by reparative deposition of new, immature sclerotic bone. It usually occurs during the postlingual period between the second and fifth decade of life. The most commonly affected location is around the oval window (fenestral otosclerosis), which results in conductive hearing loss due to stapes footplate fixation. As it undergoes a maturation process, the sclerotic bone increases in size and depth. Objective To compare the hearing outcomes and complications of stapes surgery vs cochlear implantation in patients with far advanced otosclerosis. Data Sources Medline databases (PubMed, Medscape, Scopus, Google Scholar, Cochrane, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2021. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Patients and Methods The current review followed the guidelines of preferred reporting items for systematic reviews and meta-analysis statement 2009 (PRISMA). The detailed steps of methods were described elsewhere as well as PRISMA checklist. Results The results of this meta-analysis show that comparing the outcomes and complications of cochlear implantation and stapes surgery in far advanced otosclerosis patients have different results, in some of them there was a highly favorable and recommended procedure than the other, other results declared no significant difference in postoperative outcomes. Conclusion Both Stapes surgery and CI are reliable treatment options for FAO with very close success rates. Statistics of CI are greater than Stapes surgery and CI has a consistent improvement in speech discrimination scores in comparison to Stapes surgery. Patients must receive adequate counseling regarding all the factors mentioned above and the decision must be made by surgeons and the informed patients.