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Perioperative glucocorticoid treatment does not influence early post-laser stapedotomy hearing thresholds
H Riechelmann1, M Tholen, T Keck
1Department of Otorhinolaryngology-Head Neck Surgery, University of Ulm Medical School, Germany.
Objective:
The aim of this study was to evaluate the efficiency of prophylactic perioperative glucocorticoid treatment during stapes surgery in preventing damage to the inner ear and reducing the frequency of early postoperative complications.
Study Design:
A prospective, randomized, unblinded study design was selected.
Setting:
The study was conducted at an academic tertiary referral center.
Patients:
Ninety-five consecutive patients undergoing erbium:YAG laser-assisted stapedotomy for otosclerosis between 1996 and 1999 were included.
Main Outcome Measures:
The preoperative minus postoperative (1-4 days and at least 6 weeks) average pure-tone bone conduction thresholds at 1, 2, and 4 kHz were compared in the prednisolone and control groups by the Mann-Whitney U Test. In addition, the occurrences of sensorineural hearing loss of >10 dB, nystagmus, vertigo, and tinnitus were counted and evaluated by use of the Freeman-Halton or Fisher's exact test, respectively.
Results:
Prophylactic perioperative prednisolone treatment was not able to improve the early postoperative average bone conduction thresholds or reduce the frequency of early sensorineural hearing loss (p > 0.5). The patients who received perioperative prednisolone treatment experienced postoperative vertigo more frequently than did the control patients (p < 0.05).
Conclusion:
Perioperative cortisone prophylaxis for prevention of inner ear damage during stapes surgery is ineffective and is associated with increased postoperative patient discomfort.