Short-term audiological outcomes according to stapedotomy technique: microdrill at low revolutions versus manual perforator to perform the small fenestra of the footplate. An observational prospective study.

Abstract

Introduction: Stapedotomy is currently the surgical technique of choice for treating otosclerosis. Despite this, there is not an agreement about the best technique to perform the small fenestra on the footplate, therefore multiple procedures have been proposed. The aim of this study was to investigate the hearing outcomes of microdrill and manual perforator. Material and Methods: Observational prospective study was carried out on patients that underwent stapedotomy. We analyzed the hearing threshold in two groups of patients according to the way the fenestra footplate was realized by microdrill or manual perforator. Results: A total of 113 patients were evaluated. Postoperative hearing gain of the microdrill group was 23.29 (18.58) dB HL 95% CI (18.40-28.18). In the manual perforator group, it was 22.67 (12.91) dB HL 95% CI (19.07-26.26). Both groups were statistically significant. Postoperative bone conductive hearing threshold at the frequencies of 0.5, 1 and 2 KHz and postoperative air conductive hearing threshold at the frequencies of 2 and 4 KHz showed statistically significant differences in the manual perforator group. The closure of air-bone gap was higher in the microdrill group with statistically significant differences. Conclusion: Both, manual perforator and microdrill, have good hearing outcomes at six months after surgery. Manual perforator has better audiological outcomes than microdrill. Hence, manual perforator is a safe technique and can be used in center that do not have other methods to do the small fenestra.