Is gelfoam sealing necessary in stapes surgery?

Area of Science:

• Otolaryngology
• Neurosurgery
• Surgical Innovation

Background:

• Gelfoam® is frequently employed to seal the oval window post-stapes surgery for otosclerosis.
• This practice aims to optimize surgical outcomes and minimize complications.

Purpose of the Study:

• To investigate the impact of using Gelfoam® versus not using it as a sealing material during stapes surgery.
• To compare vestibular and audiological outcomes, as well as complication rates between the two groups.

Main Methods:

• A retrospective analysis of 418 stapes surgeries performed between 2013 and 2019.
• Comparison of 215 cases using Gelfoam® with 203 control cases without sealing.
• Evaluation of primary outcomes including vestibular function and secondary outcomes such as audiological results and complications.

Main Results:

• No statistically significant differences were observed in the incidence of postoperative vertigo between the Gelfoam® group (11.6%) and the control group (8.4%).
• Audiological outcomes, measured by the average postoperative air-bone gap, were comparable, with 4.6 dB in the Gelfoam® group versus 5.3 dB in the control group.
• The study included patients with a mean age of 47 years and a mean follow-up of 50 months, with a female predominance (65.6%).

Conclusions:

• The use of Gelfoam® as a sealing material in stapes surgery for otosclerosis does not appear to influence vestibular or audiological outcomes.
• Current surgical practices involving Gelfoam® for oval window sealing may not offer distinct advantages in terms of patient recovery and hearing results.
• Further research could explore alternative sealing materials or techniques to potentially enhance outcomes in stapes surgery.