DOES PROSTHESIS DIAMETER MAKE A DIFFERENCE IN THE HEARING OUTCOME AFTER STAPEDOTOMY?

Abstract

Objective:
The objective of the study was to assess and compare the hearing improvement after stapedotomy using stapes piston of different diameters.
Materials and Methods: The study was conducted in the department of ENT and Head & Neck Surgery, Tribhuvan University Teaching Hospital from January 2014 to December 2018. This five-year study was a retrospective chart review of the patients
above 15 years of age who had undergone stapedotomy in the department. The patients had undergone stapedotomy surgery under local anaesthesia using either 0.4 mm or 0.5 mm diameter piston. Postoperatively, hearing was assessed using air conduction threshold improvement and air-bone gap improvement. The patients’ hearing evaluation was done after six weeks of
surgery and postoperative hearing was compared in patients using to the 0.4 mm, 0.5 mm or 0.6mm stapes piston.
Results: There were 56 patients assessed in the study with a slight female preponderance. The commonest age group who underwent stapedotomy was in the range of 15-30 years of age. The majority of the patients had a piston size diameter of 0.4mm followed by 0.5mm then 0.6mm. On comparing the hearing status of the patients postoperatively, both the air conduction threshold and air-bone gap showed significant hearing improvement postoperatively more on the lower frequencies.
Conclusion: The postoperative air conduction threshold and air-bone gap improvement were seen after stapedotomy. The difference in the postoperative status was more on the lower frequencies and on using the greater diameter piston size.
Keywords: Air-bone gap, Air conduction threshold, Otosclerosis, Piston, Stapedotomy