title: Day-case stapes surgery: Day-case versus inpatient stapes surgery for otosclerosis: a randomized controlled trial.
abstract: BACKGROUND
  Otosclerosis is characterized by bony deposits in the otic capsule, resulting in stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the stapes and replacing it with a prosthesis. Increasingly, stapes surgery is performed as a day-case procedure. The major drive towards day-case surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for surgery, a reduced risk of infection and most likely positively influences the patient's quality of life as a result of rapid discharge and rehabilitation. Even though stapes surgery seems well suited to a day-case approach, given the low complication rates and early recovery, evidence is scarce and of low quality.
  
  
  METHODS
  A single-center unblinded randomized controlled trial was designed to (primarily) investigate the effect of hearing outcomes of day-case stapes surgery compared to inpatient stapes surgery and (secondarily) investigate the effect of both methods on quality of life, tinnitus, vertigo and cost-effectiveness. One hundred and twelve adult otosclerosis patients who are eligible for stapes surgery will be randomly assigned to either the day-case or inpatient treatment group. The primary and secondary outcome measures will be assessed using pure-tone audiometry (at approximately 2 months and 1 year follow-up), questionnaires (at 3 months and 1 year follow-up) and costs diaries (weekly the first month after which once a month until 1 year follow-up).
  
  
  CONCLUSIONS
  This trial allows for a comparison between day-case and inpatient stapes surgery to investigate the hypothesis that day-case stapes surgery is associated with a higher quality of life and higher cost-effectiveness, while maintaining equal hearing results, compared to inpatient stapes surgery.
  
  
  BACKGROUND
  Netherlands Trial Register (www.trialregister.nl): NTR4133, registration date 21(st) August 2013.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, PO BOX 85500, 3508 GA Utrecht, The Netherlands.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Laura S M
authors.initials: LSM
authors.lastname: Derks
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, PO BOX 85500, 3508 GA Utrecht, The Netherlands.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Wegner
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, PO BOX 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Rinze A
authors.initials: RA
authors.lastname: Tange
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, PO BOX 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Digna M A
authors.initials: DMA
authors.lastname: Kamalski
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University Medical Center Utrecht, PO BOX 85500, 3508 GA Utrecht, The Netherlands.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Wilko
authors.initials: W
authors.lastname: Grolman
keywords: Audiometry; Day-case; Hearing loss; Hearing results; Inpatient; Otosclerosis; Quality of life; Stapedotomy; Tinnitus; Vertigo