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- Title
Bone Cement Fixation of Stapedotomy Prostheses: Long-term Outcomes in Primary and Revision Stapes Surgery.
- Authors
Sioshansi, Pedrom C.; Schettino, Amy; Babu, Seilesh C.; Bojrab, Dennis I.; Sargent, Eric W.; Michaelides, Elias M.; Luryi, Alexander L.; Schutt, Christopher A.
- Abstract
Objectives: To describe audiologic outcomes following hydroxyapatite bone cement fixation of stapedotomy prostheses. Methods: A retrospective case review at a tertiary neurotology referral center was performed of patients undergoing primary or revision stapedotomy between 2010 and 2017. Patients with hydroxyapatite bone cement fixation of stapes prostheses were assessed. Pre- and postoperative hearing was compared, consisting of air conduction (AC) and bone conduction (BC) pure-tone averages (PTA), air-bone gap (ABG), and word recognition scores (WRS). Short and long-term outcomes were assessed. Results: Forty-six patients with otosclerosis underwent stapedotomy with bone cement fixation: 21 primary cases and 25 revision cases, with an average follow-up time of 17 months. Mean AC PTA was 56 dB preoperatively, and 34 dB postoperatively (P <.0001), while the ABG improved on average from 27 dB to 9 dB (P <.0001). There was no significant difference in postoperative ABG between primary and revision stapes surgery (6 dB vs 10 dB, P =.07). These results persisted through long-term follow-up in a subgroup of patients with significantly longer follow-up time (mean 44 months). There was no significant change in BC PTA or word recognition scores. Three patients underwent subsequent revisions, one patient developed sensorineural hearing loss. Conclusion: Stapedotomy with bone cement fixation of the prosthesis provides excellent hearing outcomes in both primary and revision treatment of otosclerosis. Results are consistent and stable through long-term follow-up. The use of bone cement should be incorporated into the surgical armamentarium of the otologist for the prevention and treatment of loose-wire syndrome and incus necrosis.
- Subjects
PREVENTION of surgical complications; HYDROXYAPATITE; EAR surgery; HEARING; SPEECH perception; BONE cements; ACQUISITION of data methodology; RETROSPECTIVE studies; BONE conduction; TREATMENT effectiveness; PRE-tests &; post-tests; OTOSCLEROSIS; REOPERATION; MEDICAL records; CASE studies; AUDIOMETRY; DESCRIPTIVE statistics; NECROSIS; EAR ossicles
- Publication
Annals of Otology, Rhinology & Laryngology, 2021, Vol 130, Issue 7, p769
- ISSN
0003-4894
- Publication type
Article
- DOI
10.1177/0003489420971337