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Stapedectomy Versus Stapedotomy: Comparison of Results With Long‐Term Follow‐up
Author(s) -
House Howard P.,
Hansen Marlan R.,
Dakhail Abdul Aziz A. Al,
House John W.
Publication year - 2002
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 - 10.1097/00005537-200211000-00025
Subject(s) - stapedectomy , medicine , otosclerosis , bone conduction , surgery , sensorineural hearing loss , conductive hearing loss , hearing loss , significant difference , complication , audiology
Objective/Hypothesis To compare the effectiveness and long‐term stability of hearing results between stapedectomy and small fenestra stapedotomy in patients with conductive hearing loss due to otosclerosis. Study Design Retrospective review of prospectively collected audiometric data. Methods The hearing results and complication rates of 209 ears with long‐term follow‐up that underwent either stapedectomy or stapedotomy by the senior author (h.p.h.) between 1961 and 1989 were compared. Forty‐two patients underwent stapedectomy in one ear and stapedotomy in the opposite ear, permitting a paired case review of the results in these patients. The techniques were compared with respect to initial and late hearing results and change of the results over time. Results Patients undergoing stapedectomy and stapedotomy were followed for an average of 11.5 and 6.0 years, respectively. There were no statistically significant differences in initial or late postoperative pure‐tone average (PTA), PTA air–bone gap, speech discrimination scores, or incidence of sensorineural hearing loss between the two groups. Ears treated by stapedotomy showed statistically better initial and late postoperative 4‐kHz air‐conduction threshold and initial 4‐kHz air–bone gap, but the gap difference was not significant with late follow‐up. There was no significant difference in the percentage of patients with air–bone gap closure within 10 dB for any frequency other than 4 kHz at the initial postoperative test. Importantly, the successful outcomes in both groups were stable over long‐term follow‐up. Results were the same when comparing the two procedures in patients having undergone both. Conclusion These results show that, in the hands of an experienced surgeon, either technique provides satisfactory and stable long‐term results.