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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2005 September;55(3):209-16
Otoneurologic complications of stapes surgery
Redaelli de Zinis L. O., Provenzano L., Campovecchi C., Nassif N., Zanetti D., Antonelli A. R.
Clinica Otorinolaringoiatrica Università degli Studi di Brescia, Brescia
Aim. To analyze the complications of stapes surgery.
Methods. A retrospective study was performed on patients consecutively operated with a either large or small fenestra stapedectomy to analyze anatomical variants, intraoperative and postoperative complications, and to evaluate predisposing factors for vertigo, tinnitus and sensorineural hearing loss.
Results. Anatomical variants were evident in 20.5% of patients. Intraoperative complications were observed in 11% of cases and were more frequent in patients with anatomical variants (17.5% vs 9.3%; p=0.01). Sensorineural hearing loss was observed in 3.3% of patients after 6 months following the intervention, in 4.1% after 1 year, in 4.6% after 5 years, and in 6.8% after 10 years. The prevalence of sensorineural hearing loss was higher for small fenestra stapedectomy, even though this did not reach statistical significance. There was no significant difference in the prevalence of postoperative tinnitus in patients with anatomical variants (4.4% vs 4.1%), in patients submitted to large fenestra stapedectomy (5.1% vs 2.7%) and in cases with intraoperative complications (4.9% vs 4%). Postoperative vertigo was more frequent in patients with anatomical variants (22.8% vs 20.1%, p=NS), in those submitted to large fenestra stapedectomy (23.1% vs 17.1%, p=NS), and in those with intraoperative complications (27.9% vs 19.8%, p=NS).
Conclusions. Stapes surgery is more frequently complicated when anatomical variants are present, although postoperative complications are not influenced by their presence. The frequency of otoneurologic complications is similar for large or small fenestra stapedectomy. Long term sensorineural hearing loss was less frequent for stapedectomy, which could have a protective effect for the inner ear.