A Five Year Experience of Stapedotomy in a District General Hospital

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Introduction: Stapes fixation resulting in a conductive hearing loss is a condition that can be successfully treated surgically, although other common management options include observation and hearing aid(s).

Most otologists perform stapedotomy by creating a small fenestra in the stapes footplate to allow insertion of a solid piston prosthesis.

We present our outcomes following stapes surgery, in particular looking at the effect of surgery on closure of the air-bone gap, tinnitus and taste disturbance.

Methods: A retrospective case notes review of 137 consecutive stapedotomies performed by a single consultant ENT surgeon, using the Fisch Teflon-platinum piston prosthesis, was analysed over a five year period.

Results: 137 operative cases from 109 patients were identified and included into this study. The average age at operation was 46 years. Incudo-stapedotomy was performed in 88% of cases and malleo-stapedotomy in 12% of cases. The average pre-operative air-bone gap was 31.5 db HL (SD=10.70) and the average post-operative air-bone gap at 1 year was 13.8 dB HL (SD=10.45). Subjective hearing improvement was reported by 94% of patients at 1 month follow-up and 83% at 1 year. Taste disturbance was reported by 3% patients at 1 year follow up. Pre-operative tinnitus was present in 50% of patients, and this reduced to 16% at 1 year.

Conclusion: Our study has shown a statistically significant reduction in the air-bone gap and improvement in hearing in all patients who had stapedotomy performed for otosclerosis. In this series, there was an improvement in post-operative tinnitus with minimal complication rates overall.

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