Prospective study on Stapedius tendon intact stapedotomy

Aims: Stapedotomy is performed to improve the hearing in otosclerosis patients. High frequency sensorineural hearing loss is a distressing but very common post operative complication in stapedotomy patients. This results in poor speech discrimination and patient dissatisfaction. The aim of the study is to compare the high frequency sensorineural hearing loss caused by stapedius tendon intact stapedotomy versus stapedius tendon cut stapedotomy.
Materials and Method: This is an observational cohort study with a sample size of 62. There are two groups. Group A, Stapedius tendon intact stapedotomy patients were selected prospectively (n=21). Group B, Stapedius tendon cut stapedotomy patients were selected retrospectively (n=41). Pure tone audiometry was performed in both groups, both pre-operatively and 1-month after the surgery.
Results: 25 patients from 41 have high frequency sensorineural hearing loss in stapedius tendon cut stapedotomy group (Group B- 61%). 9 patients from 21 have high frequency sensorineural hearing loss in stapedius tendon intact stapedotomy group (Group A- 43%). Postoperative air bone-gap is 6.2dB in group A and 5dB in group B. Air-bone gap closure is 25dB in group A and 27dB in group B. Average sensory neural hearing loss is 0.7dB in group A, but there is an improvement of 1dB in group B.
Conclusion: Stapedius tendon intact stapedotomy is significantly better than stapedius tendon cut stapedotomy with regard to the post-operative high frequency sensorineural hearing loss. But postoperative air-bone gap, postoperative bone conduction threshold and average sensorineural hearing loss is marginally better in stapedius tendon cut stapedotomy group.