Stapedotomy vs stapedectomy. Comparison of hearing results

The Authors investigated 200 patients, selected at random from an operative case-report of 1857 subjects, in order to evaluate hearing results of stapes surgery and to compare the recovery obtained using both small (0.7 mm footplate hole) and large fenestra stapedectomy. More precisely, after 1 week and 6 months, they examined audiological findings (air, bone conduction and cochlear reserve) before performing the operation in order to evaluate the following problems: persisting conductive gap at low frequencies, sensorineural hearing loss at high frequencies, prognosis in advanced stages (compromised pre-operative bone conduction), preservation of hearing over time. Firstly, data from our research indicate extremely successful results in stapes surgery; in particular, hearing improvement seems to be more frequent for middle-low tones (in 98% of patients), due to the higher rate of sensorineural deficit at high frequencies, which are however characterized by a more complete closure of the conductive gap. However with stapedotomy better hearing recovery is obtained and in a greater number of patients with a lower evidence of bone conduction impairment. Such an advantage increases even further from the time of surgery (p significant after 6 months on every frequency) and particularly in cases where disease is advanced.