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Our aim was to determine whether perioperatively administered corticosteroid treatment has any beneficial effect on the outcome of stapes surgery, with special regard to the audiological results and early postoperative morbidity.
84 CO2 laser stapedotomies performed in our institute between 2013 and 2018 were included in our investigation. All cases underwent preoperative and mid-term postoperative pure-tone audiometric evaluation. Vestibular complications were also evaluated. The cases were subdivided into two groups, 23 patients received perioperative i.v. methylprednisolone treatment (“S”) while the other 61 patients (“nS”) did not receive any adjuvant pharmacological therapy. The data were analyzed retrospectively using IBM SPSS Statistics.
CO2 laser stapedotomy proved to be a successful intervention with a significant improvement in ABG and AC thresholds as well. Long-term BC levels were significantly better compared to preoperative ones in the S group; however, in the nS group, no difference could be shown. Hearing and ABG gain were significantly superior in group S [28.1 dB (SD11.2) vs. 18.1 dB (SD 10.9) and 23.9 dB(SD 9.8) vs. 17.2 dB (SD 9.5), respectively].
No significant inner ear damage was detectable in the results of our CO2 laser stapedotomy method; however, the positive effect of corticosteroid treatment could be demonstrated through the postoperative hearing levels. We found no statistical difference in early postoperative morbidity. According to our data, the routine administration of corticosteroids during stapes surgery could be an issue worthy of consideration. The effects of perioperative treatment vs that on the first day after surgery, and topical vs. systemic treatment could be the subject of further investigation in a prospective manner.
Shea JJ Jr (1958) Fenestration of the oval window. Ann Otol Rhinol Laryngol 67(4):932–951 CrossRef
Cheng HCS, Agrawal SK, Parnes LS (2018) Stapedectomy Versus Stapedotomy. Otolaryngol Clin North Am 51(2):375–392 CrossRef
Fang L et al (2014) Laser versus non-laser stapedotomy in otosclerosis: a systematic review and meta-analysis. Auris Nasus Larynx 41(4):337–342 CrossRef
Brase C et al (2013) Bone conduction after stapes surgery: comparison of CO 2 laser and manual perforation. Otol Neurotol 34(5):821–826 CrossRef
Kamalski DM et al (2014) Comparing mechanical effects and sound production of KTP, thulium, and CO2 laser in stapedotomy. Otol Neurotol 35(7):1156–1162 PubMed
Andersen SA, Ohman MC, Sorensen MS (2015) The stability of short-term hearing outcome after stapedotomy: a prospective database study. Acta Otolaryngol 135(9):871–879 CrossRef
Committee on Hearing and Equilibrium (1995) Committee on hearing and equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 113(3):186–187. https://doi.org/10.1016/S0194-5998(95)70103-6 CrossRef
Gurgel RK et al (2012) Is it valid to calculate the 3-kilohertz threshold by averaging 2 and 4 kilohertz? Otolaryngol Head Neck Surg 147(1):102–104 CrossRef
Kiefer J et al (2007) Protecting the cochlea during stapes surgery: is there a role for corticosteroids? Adv Otorhinolaryngol 65:300–307 PubMed
Ye Q et al (2007) Application of a corticosteroid (Triamcinolon) protects inner ear function after surgical intervention. Ear Hear 28(3):361–369 CrossRef
Mangham CA, Jr., Neel J, Mangham HF (2008) Success of five stapes prostheses evaluated by Kaplan-Meier product-survival procedure . Otol Neurotol 29(7): 900–904. CrossRef
Wegner I et al (2016) A systematic review of the effect of piston diameter in stapes surgery for otosclerosis on hearing results. Laryngoscope 126(1):182–190 CrossRef
Çelik ÇMC, Aliyeva A, Düzenli U, Dalgıç A (2018) The effect of perioperative I.V. corticosteroids on hearing outcome following stapedotomy . ENT Updates, 8(2): 82–87
Riechelmann H et al (2000) Perioperative glucocorticoid treatment does not influence early post-laser stapedotomy hearing thresholds. Am J Otol 21(6):809–812 PubMed
Wilson WR, Byl FM, Laird N (1980) The efficacy of steroids in the treatment of idiopathic sudden hearing loss. A double-blind clinical study. Arch Otolaryngol 106(12):772–776 CrossRef
El-Hennawi DM et al (2005) Efficacy of intratympanic methylprednisolone acetate in treatment of drill-induced sensorineural hearing loss in guinea pigs. J Laryngol Otol 119(1):2–7 CrossRef
Enticott JC et al (2011) Methylprednisolone applied directly to the round window reduces dizziness after cochlear implantation: a randomized clinical trial. Audiol Neurootol 16(5):289–303 CrossRef
Kanona H, Bhutta MF, Lavy J (2017) Our approach to revision stapes surgery and the outcomes from 49 procedures at a UK tertiary centre. Clin Otolaryngol 42(4):931–935 CrossRef
Holund B et al (1982) The effect of D-penicillamine and methylprednisolone on the morphology of experimental granulation tissue in rats. Acta Pathol Microbiol Immunol Scand A 90(1):51–55 PubMed
Hettrich CM et al (2016) The effect of myofibroblasts and corticosteroid injections in adhesive capsulitis. J Shoulder Elbow Surg 25(8):1274–1279 CrossRef
Li J et al (2006) Intraoperative intraocular triamcinolone injection prophylaxis for post-cataract surgery fibrin formation in uveitis associated with juvenile idiopathic arthritis. J Cataract Refract Surg 32(9):1535–1539 CrossRef
Shaban M et al (2013) Effects of sodium hyaluronate and methylprednisolone alone or in combination in preventing epidural fibrosis. Neurol Res 35(8):851–856 CrossRef
Nakano M, et al. (1998) Postlaminectomy adhesion of the cauda equina. Inhibitory effects of anti-inflammatory drugs on cauda equina adhesion in rats. Spine (Phila Pa 1976) 23(3): 298–304 CrossRef
Vander Salm TJ et al (1986) Prevention of postoperative pericardial adhesions. An animal study. Arch Surg 121(4):462–467 CrossRef
- Mid-term evaluation of perioperative i.v. corticosteroid treatment efficacy on overall and audiological outcome following CO2 laser stapedotomy: a retrospective study of 84 cases
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