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Does the diameter of the stapes prosthesis really matter? A prospective clinical study
Author(s) -
Bernardeschi Daniele,
Seta Daniele,
Canu Giuseppina,
Russo Francesca Yoshie,
Ferrary Evelyne,
Lahlou Ghizlene,
Sterkers Olivier
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27021
Subject(s) - medicine , bone conduction , stapes , stapes surgery , analysis of variance , prosthesis , repeated measures design , significant difference , piston (optics) , prospective cohort study , sensorineural hearing loss , surgery , orthodontics , middle ear , audiology , hearing loss , otosclerosis , statistics , physics , mathematics , wavefront , optics
Objectives/Hypothesis To evaluate the influence of the diameter of stapes prosthesis on functional outcomes in stapes surgery. Study Design Prospective cohort study. Methods Fifty consecutive small fenestra stapedotomies performed using a 0.4‐mm‐diameter prosthesis were compared with 50 consecutive small fenestra stapedotomies carried out using a 0.6‐mm‐diameter piston. Audiological assessment following the recommendations of the Committee on Hearing and Equilibrium was performed 1 month after surgery. Postoperative complications between the two groups were noted. Results There were no statistically significant differences in demographic data between the two groups, and no differences in preoperative bone‐conduction (BC) or air‐conduction (AC) hearing thresholds for all frequencies (analysis of variance [ANOVA] and χ 2 tests). No differences were found in the mean preoperative BC and AC pure‐tone average and air‐bone gap (ABG). In the postoperative evaluation, a statistically significant difference was found for the mean AC gain (20 ± 8.7 vs. 24 ± 11.5, P = .042, ANOVA) as well as for the postoperative AC threshold at 0.125 and 0.25 kHz and the postoperative BC threshold at 0.25 kHz ( P < .01, ANOVA). A postoperative ABG ≤10 dB was obtained in 90% and 94% of patients in the 0.4‐mm‐ and 0.6‐mm‐diameter piston groups, respectively (difference not significant, χ 2 test). No postoperative dead ear and/or sensorineural hearing loss was noted in either group. Conclusions The 0.6‐mm piston allowed a statistically significant higher AC gain compared with the 0.4‐mm diameter piston. A larger diameter piston may be preferable if there are no anatomical or technical reasons that would favor a smaller prosthesis. Level of Evidence 2b Laryngoscope , 1922–1926, 2018