title: Manual stapedotomy still holds good in the era of laser.
abstract: BACKGROUND
  In the present era of stapedotomy, there is an inevitable role for laser. But the conventional technique with manual burr still has its own merits in various settings such as usage in resource poor setting in developing countries and avoidance of laser hazards.
  
  
  OBJECTIVE
  To evaluate the audiometric outcomes after manual stapedotomy.
  
  
  METHODS
  The present study was retrospective record-based study. Patients who have been diagnosed otosclerosis and those who were not willing for surgery with laser, but gave consent for manual stapedotomy were included for the study.
  
  
  METHODS
  Preoperatively, and at each subsequent post-operative follow-up visits, patients were required to undergo a pure-tone audiogram. The air-bone gaps at the end of 6 months were used for final analysis.
  
  
  METHODS
  Data was analyzed with using Statistical Package for Social Sciences (SPSS) version 12 (Chicago, IL, USA). Descriptive frequency distributions, mean, standard deviation of audiometric data were calculated. The paired t test was done to see the improvement in the air bone gap post-operatively.
  
  
  RESULTS
  The mean age of presentation is 32.2 years. Overall, the male:female ratio was found to be 1:1.2. Post-operative air bone closure to 15 decibels was obtained in 80% of patients. There was no significant correlation between the pre-operative hearing loss and post-operative gain, age, and gender of distribution of focus.
  
  
  CONCLUSIONS
  The post-operative hearing after stapedotomy has been remarkable in all the patients even with manual burr. There were no major vestibular complications in any of these patients. The study has shown that the significant post-operative hearing results can be still achieved with meticulous surgery by an experienced surgeon with manual burr in the present laser era.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. gsivram@gmail.com
authors.forename: Sivaraman
authors.initials: S
authors.lastname: Ganesan
authors.forename: S
authors.initials: S
authors.lastname: Anuprasad
authors.forename: Sisir Kumar
authors.initials: SK
authors.lastname: Patra
authors.forename: Pradipta Kumar
authors.initials: PK
authors.lastname: Parida
authors.forename: Suria
authors.initials: S
authors.lastname: Gopalakrishnan
authors.forename: Nishikanta
authors.initials: N
authors.lastname: Verma
mesh_terms: D000328:Adult; D005260:Female; D006309:Hearing; D006801:Humans; D008297:Male; D010040:Otosclerosis / Q000601:surgery*; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome