Audiometric and Vestibular Function after Classic and Reverse Stapedotomy.

Area of Science:

• Otolaryngology
• Neurosurgery
• Audiology

Background:

• Otosclerosis management frequently involves stapedotomy.
• Reverse stapedotomy is an alternative surgical approach.
• The impact of reverse stapedotomy on vestibular function and hearing outcomes requires investigation.

Purpose of the Study:

• To compare hearing improvement and vestibular function between classic and reverse stapedotomy.
• To assess the safety and efficacy of reverse stapedotomy in otosclerosis treatment.

Main Methods:

• A cohort of 123 patients underwent either classic or reverse stapedotomy using a fiber-optic argon laser.
• Audiological assessments included pure tone average, air-bone (AB) gap, overclosure, and AB gap closure.
• Vestibular evaluation involved pre- and postoperative rotatory tests measuring nystagmus parameters.

Main Results:

• Both procedures showed comparable hearing improvements, with a mean AB gap closure of 20.3 ± 8.8 dB.
• Reverse stapedotomy demonstrated a marginally superior, though not statistically significant, AB gap closure (7.5 dB) compared to classic stapedotomy (10.0 dB).
• No significant differences in vestibular function, assessed by rotatory tests, were observed between the two surgical groups.

Conclusions:

• Reverse stapedotomy is a safe surgical technique for otosclerosis, yielding comparable postoperative outcomes to classic stapedotomy.
• This technique may reduce risks such as floating footplate and sensorineural hearing loss.
• Reverse stapedotomy can facilitate the surgical learning curve for less experienced ear surgeons.