Outcome of hearing in stapedectomy versus stapedotomy in nonendemic areas

Abstract

Background and Objectives: Stapedectomy and stapedotomy are the standard techniques for surgical treatment of stapes fixation. Both techniques differ in the size of the created opening in the stapes footplate and the type of prosthesis used. The aim of the study is to evaluate the outcomes of hearing following the two surgical techniques. Methods: One hundred and forty-nine medical records of patients who underwent stapedectomy or stapedotomy between the years 1988 and 2011 were reviewed. The subjects were classified into two groups including stapedectomy and stapedotomy. The clinical and immediate pre- and postoperative air-conduction (AC) threshold, bone conduction, and air-bone gap (ABG) were compared between the two groups. Results: The average age of patients included (n = 149) was 34.4 years at the time of surgery. The pure-tone average calculated for AC for clinical and immediate preoperative and postoperative was 57.6, 58.9, and 35.3 dB, respectively. The ABG calculated for clinical, immediate preoperative, and postoperative was 37, 36.9, and 14.5 dB, respectively. The majority of the patients (80.5%) underwent surgery for otosclerosis. Stapedectomies were done for 60.4% versus 39.6% stapedotomies. Preoperatively, the majority of patients fall within the class of moderate to moderate-severe hearing loss. Closure of ABG to 10 dB or more was achieved in 50.4% of the cases. Postoperative ABG was statistically different (P = 0.002) between the stapedectomy (16.79 dB) versus stapedotomy (10.85 dB) group. Conclusions: Stapedotomy cases were better than stapedectomy ones in closing the ABG. The frequency (250 Hz) AC threshold was better in the stapedotomy group compared to the stapedectomy one in a postoperative audiogram. No statistical difference was observed between the two groups in the other frequencies.