Assessment of functional outcomes after stapedotomy with and without preservation of stapes suprastructures

Abstract Background Stapedotomy is the treatment standard for conductive hearing loss in individuals with otosclerosis considering the advances in surgical procedures, varieties of prostheses, and surgical materials to lower the risks of surgery and provide superior functional results. The purpose of the study was to analyze the functional outcomes following stapedotomy with and without preservation of stapes suprastructures. Methods This randomized controlled trial involved 40 patients with conductive hearing loss due to clinical otosclerosis. Patients were randomly divided into two groups, 20 patients each. Group I patients were subjected to cutting and removing stapedial suprastructures, while Group II patients had preservation of stapedial suprastructures. Tuning fork tests and audiological evaluation were performed for every patient preoperative and 6 months postoperative. Results Group 1 patients showed a statistically significant change of Carhart notch being absent in more patients postoperatively, while group 2 patients showed no change in Carhart notch postoperatively. When comparing preoperative and postoperative mean bone conduction threshold, no statistically significant difference was seen in either group I or group II. Regarding mean postoperative AC threshold, severity of conductive deafness, ABG, and postoperative ABG closure < 10 dB, there was a significant difference between the two groups with better outcomes in group I. In terms of postoperative Rinne and Weber tests, there was a significant distinction between groups I and II with more cases having positive Rinne test and midline Weber test in group I. Group I had a higher incidence of postoperative complications, with significantly more immediate postoperative vertigo in group I. Conclusions Stapedotomy without stapedial suprastructural preservation had better functional outcomes compared to stapedotomy with stapedial suprastructural preservation, with a higher complication rate seen in stapedotomy without stapedial suprastructures preservation mainly immediate vertigo.