title: Hearing outcomes in stapes surgery: a comparison of fat, fascia, and vein tissue seals.
abstract: OBJECTIVE
  To compare short- and long-term hearing results following stapedectomy using 3 different oval window grafting materials with the same stapes prosthesis.
  
  
  METHODS
  Database review.
  
  
  METHODS
  Tertiary referral private practice.
  
  
  METHODS
  Subjects were ears that underwent stapedectomy for otosclerosis, with placement of fat, fascia, or vein as an oval window seal and reconstruction with a titanium bucket handle prosthesis. A total of 365 procedures met these inclusion criteria: 98 fat grafts, 135 fascia grafts, and 132 vein grafts. Outcome measures included short-term (<1 year) and long-term follow-up air-bone gap. We compared the preoperative and postoperative amount of change in air-bone gap and preoperative and postoperative amount of change in the high-frequency bone conduction average.
  
  
  RESULTS
  Overall median times to short-term and long-term follow-ups were 2.2 months and 36.1 months, respectively. There were no statistically significant differences between the 3 tissue seal groups in the amount of change in air-bone gap. There was no significant difference in amount of change in high-frequency bone conduction (representing sensorineural hearing level) between the 3 tissue seal groups. Most patients in all 3 groups had an air-bone gap at long-term follow-up of ≤ 10 dB (fat, 79.5%; fascia, 78.8%; and vein, 75.6%), with 90.3% of all patients at ≤ 20 dB.
  
  
  CONCLUSIONS
  In both the short-term postoperative period and long-term follow-up, there were no significant differences in hearing results among 3 types of tissue seals of the oval window in stapes surgery. Fat, fascia, and vein grafts all provide satisfactory hearing outcomes in stapedectomy.
authors.affiliation: The Ear Institute of Chicago, Hinsdale, Illinois 60521, USA. r-wiet@northwestern.edu
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wiet
authors.forename: Robert A
authors.initials: RA
authors.lastname: Battista
authors.forename: R Mark
authors.initials: RM
authors.lastname: Wiet
authors.forename: Andrew T
authors.initials: AT
authors.lastname: Sabin
mesh_terms: D000273:Adipose Tissue / Q000637:transplantation; D000328:Adult; D000704:Analysis of Variance; D001301:Audiometry, Pure-Tone; D015331:Cohort Studies; D005205:Fascia / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000175:diagnosis / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013201:Stapes Surgery / Q000009:adverse effects / Q000379:methods*; D062606:Tertiary Care Centers; D013997:Time Factors; D016378:Tissue Transplantation / Q000379:methods*; D016896:Treatment Outcome; D014680:Veins / Q000637:transplantation