Standardizing the size of pistons in both sexes and comparing the outcome of reverse stapedotomy: our experience

Authors

  • Tushar K. Ghosh Department of ENT, Ghosh ENT Foundation, Kolkata, West Bengal, India
  • Debayan Dey Department of ENT, Ghosh ENT Foundation, Kolkata, West Bengal, India https://orcid.org/0000-0001-6698-3837

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20240698

Keywords:

Stapedotomy, Reverse stapedotomy, Piston size, Outcome

Abstract

Background: Stapedotomy is one of the most fascinating surgery in otology. Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patients' quality of life.

Methods: Prospective observational study conducted at Ghosh ENT foundation, Kolkata from May 2021 to May 2023 to study the outcome of reverse stapedotomy with microscope and the length of the piston used.

Results: Our study comprised of 192 ears operated for otosclerosis, 101 were males and 91 were females. 37 patients were misdiagnosed and prescribed hearing aids without being suggested stapedotomy. The most common associated complaint was tinnitus in both the sexes and only 1 patient complained of vertigo. The most common post op complication was vertigo followed by dysgeusia, Tympanomeatal flap tear was observed in a handful cases and repaired by a tympanoplasty. Our method creates minimal complication and reduces the duration of surgery. We noticed that the average length of the piston required is 4.25 mm in females while for males it is 4.5 mm. only 3 female patients were fitted with 4.5 mm piston. Patients operated by our stapedotomy technique showed that the ABG closure within 10 dB could be achieved in 87% and within 20 dB in 97% of cases without any otologic complications.

Conclusions: A good and favourable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and an appropriate surgical technique. This will ultimately lead to less post-operative complications and the need for revision surgery.

Metrics

Metrics Loading ...

References

Nayak GK, Pegu K, Deka H, Bora N, Otosclerosis-A Clinical Study. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.

Gulya AJ, Minor LB, Poe D. Surgery for otosclerosis. In: Glasscock-Shambaugh: Surgery of the ear. 6th ed. Beijing: People’s Medical Publishing House; 2010.

Scott-Brown WG., Watkinson JC, Clarke R. Otosclerosis. In: Scott-Brown’s otorhinolaryngology: Head and Neck Surgery. 8th ed. Boca Raton: CRC Press; 2009:1061-90.

Hashemi B, Bozorgi H, Sehat M. A review on reversal stapedotomy outcome and associated factors. Oper Tech Otolayngol Head Neck Surg. 2010;31:e47-52.

Moneir W, Khafagy YW, Salem NN, Hemdan A. Endoscopic stapedotomy: classic versus reversal technique. Eur Arch Otorhinolaryngol. 2023;280(8): 3653-9.

Fisch U. Stapedotomy versus stapedectomy. Am J Otol. 1982;4:112-7.

Lovato A, Kraak J, Hensen EF. A critical look into stapedotomy learning curve: influence of patient characteristics and different criteria defining success. Ear Nose Throat J. 2021;100(5):368-74.

Lang EE, Waheed K, Colreavy M, Burns H. A retrospective review of stapes surgery following introduction of 'reversal of the steps' technique. Clin Otolaryngol Allied Sci. 2004;29(6):571-3.

Fiorino F, Barbieri F. Reversal of the steps stapedotomy technique with early removal of the posterior crus: early postoperative results: how we do it. Clin Otolaryngol. 2008;33(4):359-62.

Malafronte G, Filosa B. Fisch's reversal steps stapedotomy: when to use it? Otol Neurotol. 2009;30(8):1128-30.

Häusler R. Fortschritte in der Stapeschirurgie. Laryngorhinootol. 2009;79:S95-139.

Rangheard AS, Marsot-Dupuch K, Mark AS, Meyer B, Tubiana JM. Post-operative complications in otospongiosis: usefulness of MR imaging. Am J Neuroradiol. 2001;22:1171-8.

Lescanne E, Moriniere S, Gohler C, Manceau A, Beutter P, Robier A. Retrospective case study of carbon dioxide laser stapedotomy with lens-based and mirror-based micromanipulators. J Laryngol Otol. 2003;117:256-60.

Mahendran S, Hogg R, Robinson JM. To divide or manipulate the chorda tympani in stapedotomy. Eur Arch Otorhinolaryngol. 2005;262:482-7.

House HP. Early and late complications of stapes surgery. Arch Otolaryngol. 1963;78:606-13.

Downloads

Published

2024-03-26

How to Cite

Ghosh, T. K., & Dey, D. (2024). Standardizing the size of pistons in both sexes and comparing the outcome of reverse stapedotomy: our experience. International Journal of Otorhinolaryngology and Head and Neck Surgery, 10(2), 197–201. https://doi.org/10.18203/issn.2454-5929.ijohns20240698

Issue

Section

Original Research Articles