The effect of piston diameter in primary stapes surgery on surgical success.
Eur Arch Otorhinolaryngol
; 281(6): 2931-2939, 2024 Jun.
Article
in En
| MEDLINE
| ID: mdl-38273045
ABSTRACT
PURPOSE:
To evaluate the effect of piston diameter in patients undergoing primary stapes surgery on audiometric results and postoperative complications.METHODS:
A retrospective single-center cohort study was performed. Adult patients who underwent primary stapes surgery between January 2013 and April 2022 and received a 0.4-mm-diameter piston or a 0.6-mm-diameter piston were included. The primary and secondary outcomes were pre- and postoperative pure-tone audiometry, pre- and postoperative speech audiometry, postoperative complications, intraoperative anatomical difficulties, and the need for revision stapes surgery. The pure-tone audiometry included air conduction, bone conduction, and air-bone gap averaged over 0.5, 1, 2 and 3 kHz.RESULTS:
In total, 280 otosclerosis patients who underwent 321 primary stapes surgeries were included. The audiometric outcomes were significantly better in the 0.6 mm group compared to the 0.4 mm group in terms of gain in air conduction (median = 24 and 20 dB, respectively), postoperative air-bone gap (median = 7.5 and 9.4 dB, respectively), gain in air-bone gap (median = 20.0 and 18.1 dB, respectively), air-bone gap closure to 10 dB or less (75% and 59%, respectively) and 100% speech reception (median = 75 and 80 dB, respectively). We found no statistically significant difference in postoperative dizziness, postoperative complications and the need for revision stapes surgery between the 0.4 and 0.6 mm group. The incidence of anatomical difficulties was higher in the 0.4 mm group.CONCLUSION:
The use of a 0.6-mm-diameter piston during stapes surgery seems to provide better audiometric results compared to a 0.4-mm-diameter piston, and should be the preferred piston size in otosclerosis surgery. We found no statistically significant difference in postoperative complications between the 0.4- and 0.6-mm-diameter piston. Based on the results, we recommend always using a 0.6-mm-diameter piston during primary stapes surgery unless anatomical difficulties do not allow it.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Otosclerosis
/
Postoperative Complications
/
Audiometry, Pure-Tone
/
Stapes Surgery
/
Bone Conduction
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur Arch Otorhinolaryngol
Journal subject:
OTORRINOLARINGOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Países Bajos