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Related Experiment Video

Updated: Jun 24, 2026

Techniques of Endoscopic Ossiculoplasty
09:07

Techniques of Endoscopic Ossiculoplasty

Published on: January 26, 2024

Scan for Success? Number Needed to Scan and Management Changes in Preoperative Otosclerosis: Quantitative Analysis.

Omer J Ungar1, Adi Brenner2, Daniel Zikk1

  • 1Departments of Otolaryngology-Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky University Medical Center, Gray Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|June 23, 2026
PubMed
Summary

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Preoperative high-resolution temporal bone CT scans changed management in 14% of stapes surgery patients. The number of images needed to detect a management-altering finding was 38, improving surgical planning.

Area of Science:

  • Otolaryngology
  • Radiology
  • Neurosurgery

Background:

  • Otosclerosis is a common cause of hearing loss requiring stapes surgery.
  • Preoperative imaging is crucial for surgical planning and patient selection.
  • High-resolution temporal bone computed tomography (HR-TBCT) provides detailed anatomical information.

Purpose of the Study:

  • To determine the number of images needed (NNS) on HR-TBCT to identify changes in management for primary stapes surgery.
  • To quantify the yield of HR-TBCT in detecting clinically significant temporal bone pathology in otosclerosis patients.

Main Methods:

  • Retrospective cohort study of 892 patients undergoing primary stapes surgery.
  • Review of medical records and preoperative HR-TBCT scans between 2010 and 2025.
Keywords:
enlarged vestibular aqueduct. persistent stapedial arterylateral ossicular chain fixationotosclerosisoverhanging facial nervesuperior semicircular canal dehiscence

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  • Comparison of CT findings with intraoperative findings to identify management-altering pathologies.
  • Main Results:

    • HR-TBCT revealed management-altering temporal bone pathology in 14% of patients.
    • The cumulative number of images needed (NNS) for at least one management change was 38.
    • Identified pathologies included third window lesions, ossicular fixation, and facial nerve anomalies.

    Conclusions:

    • Routine preoperative HR-TBCT is valuable, identifying significant pathology in 14% of stapes surgery candidates.
    • HR-TBCT improves patient selection, informed consent, and reduces intraoperative complications.
    • Integrating HR-TBCT enhances presurgical counseling and planning for stapes surgery.