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A comparison of hearing results following stapedotomy under local versus general anesthesia

  • Otology
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Abstract

Advances in operative technique, instrumentation, and prosthesis design in otosclerosis surgery continue since Shea performed the first successful surgery. This is the first analysis to specifically compare post-operative hearing outcomes following stapedotomy surgery performed under local versus general anesthesia. Hearing outcomes were further stratified by comparing conventional perforator and Er:YAG laser ablation perforation techniques. Pre- and post-operative audiograms were retrospectively analyzed together with the method of anesthesia and the perforation technique for all patients with otosclerosis who underwent stapedotomy between 1998 and 2007. Pre-operative individual standard audiometry frequency thresholds (IFTs), air (AC) and bone conduction pure tone averages (PTA), and air bone gaps (ABG) were compared against post-operative results. Differences between pre- and post-operative PTAs and ABGs were compared between patients who received stapedotomy under local versus general anesthesia, as well as for patients who underwent conventional versus Er:YAG laser ablation perforations. Eighty-six patients were identified of which 24 % (n = 21) received local and 76 % (n = 65) received general anesthesia. Post-operative audiograms were available for 84 and 48 patients, respectively. Significant improvements were seen across all groups for standard 4-frequency AC-PTA and ABG and for IFTs up to 3 kHz. No significant difference was seen for IFTs between 4 and 6 kHz. A significant decline in post-operative hearing thresholds was seen at 8 kHz. Significant improvements in PTA and ABG were seen for all groups. There was a trend toward general compared to local anesthesia post-operative hearing results furthermore in combination with conventional perforation technique then with laser technique.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    Maureen Loewenthal, Chia-Jung Busch, Rainald Knecht & Carsten V. Dalchow

  2. Department of Otorhinolaryngology, Head and Neck Surgery, McGill University, Montréal, Canada

    Nathan Jowett

Authors
  1. Maureen Loewenthal
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  2. Nathan Jowett
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  3. Chia-Jung Busch
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  4. Rainald Knecht
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  5. Carsten V. Dalchow
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Correspondence to Maureen Loewenthal.

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Loewenthal, M., Jowett, N., Busch, CJ. et al. A comparison of hearing results following stapedotomy under local versus general anesthesia. Eur Arch Otorhinolaryngol 272, 2121–2127 (2015). https://doi.org/10.1007/s00405-014-3014-6

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  • DOI: https://doi.org/10.1007/s00405-014-3014-6

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