ABSTRACT
Objective: To compare the functional outcomes and complications of stapedotomy with and without vein graft interposition
Design: Retrospective case study
Setting: Tertiary referral hospital
Subjects: Sixty otosclerosis patients [66 ears] that underwent primary stapedotomy surgery and followed up for at least 6 months
Interventions: Stapedotomy with vein graft interposition [n = 36] versus stapedotomy without interposition [n = 30]
Main outcome measures: Mean postoperative 4-frequency [500Hz, 1000Hz, 2000Hz, 4000Hz] air-bone gap, postoperative hearing gains for individual frequencies, sensorineural hearing loss and vertigo
Results: The mean postoperative 4-frequency [500Hz, 1000Hz, 2000Hz, 4000Hz] air-bone gap with interposition was significantly higher than without interposition [16.4 +/- 9.4 dB versus 10.7 +/- 7.4 dB, respectively]. Analyses of postoperative hearing gains revealed higher gains without interposition in all frequencies, significant for frequencies at 500Hz and 1000Hz in AC, and 4000 Hz in BC thresholds. Although the frequency of sensorineural hearing loss and vertigo did not differ between groups, sensorineural hearing loss tended to be higher with vein graft interposition
Conclusion: Stapedotomy without interposition required less manipulation, thereby leading to satisfactory results without major complications. Difficulties in performing the vein graft interposition technique requiring more manipulations and skill may be a disadvantage. Prospective randomized studies with larger series comparing different techniques can better evaluate the results