Classic and reversal steps stapedotomy performed with CO2 laser: a comparative analysis

The objective of this paper is to evaluate and compare hearing outcomes, intraoperative and postoperative complications and tinnitus characteristics, with particular regard to the effects of stapes surgery on the course of tinnitus. Two groups were evaluated: one group of patients were treated with classical stapedotomy and the second group was composed of patients who underwent reversal technique. Eighty-four patients aged between 22 and 62 years with otosclerosis were divided into two groups: group 1 (n = 49, 17 male, mean age 38, patients treated with classic stapedotomy) and group 2 (n = 35, 13 male, mean age 40, patients treated with reversal stapedotomy). Classical and reversal stapedotomy techniques were performed using CO2 laser; self-crimping titanium piston prosthesis were positioned in patients treated with reversal stapedotomy and classical stapedotomy. Preoperative and postoperative audiometric evaluation using pure tone audiometry (air-bone gap (ABG), bone-conduction thresholds and air-conduction thresholds). Tinnitus handicap inventory (THI) scale and intraoperative/postoperative complications were assessed in both groups. Wilcoxon's test and Friedman's test followed by post hoc analysis were used. There were no statistically significant differences in ABG, air conduction, bone conduction, and THI score variations after surgery between the two groups. Complications in both groups were not significant, and different. In conclusion, reversal and classic stapedotomies performed with CO2 laser can be considered efficient, safe and reliable techniques considering the hearing outcomes and complications recorded.