The influence of the sequence of surgical steps on complications rate in stapedotomy.
OBJECTIVE
To assess whether the incidence of complications of stapes surgery depended on the sequence of surgical steps and CO2 laser use in stapes surgery.


METHODS
Retrospective and prospective analysis of 420 consecutive stapedotomies was set in tertiary referral University Hospital.


METHODS
376 patients with otosclerosis in whom 420 primary stapedotomies were performed.


METHODS
Stapedotomy under local anesthesia using manual perforators and CO2 laser.


METHODS
The incidence of incus subluxation, floating footplate during stapedotomy.


RESULTS
Comparison of the incidence of incus luxation in groups with the piston inserted after removal of the stapes arch, and groups with the piston inserted on the intact ossicular chain showed statistical significance. In the group where perforation of the footplate was performed after removal of the stapes arch floating footplate occurred more often than in groups with reversed sequence of steps.


CONCLUSIONS
Perforation of the footplate before removal of stapes arch reduces the risk of floating footplate, and placing the prosthesis on the incus before removal of stapes arch reduces the risk of subluxation of the incus. CO2 laser stapedotomy with reversed sequence of steps was the safest method of stapes surgery.
Szymański
Marcin
M
Department of Otolaryngology Head and Neck Surgery, Medical University of Lublin, Poland. marcinszym@poczta.onet.pl
Gołabek
Wiesław
W
Morshed
Kamal
K
Siwiec
Henryk
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000295:instrumentation* / Q000379:methods*