A comparison of hearing results following stapedotomy under local versus general anesthesia
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A comparison of hearing results following stapedotomy under local versus general anesthesia. / Loewenthal, Maureen; Jowett, Nathan; Busch, Chia-Jung; Knecht, Rainald; Dalchow, Carsten V.
in: EUR ARCH OTO-RHINO-L, Jahrgang 272, Nr. 9, 09.2015, S. 2121-7.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - A comparison of hearing results following stapedotomy under local versus general anesthesia
AU - Loewenthal, Maureen
AU - Jowett, Nathan
AU - Busch, Chia-Jung
AU - Knecht, Rainald
AU - Dalchow, Carsten V
PY - 2015/9
Y1 - 2015/9
N2 - Advances in operative technique, instrumentation, and prosthesis design in otosclerosis surgery continue since Shea performed the first successful surgery. This is the first analysis to specifically compare post-operative hearing outcomes following stapedotomy surgery performed under local versus general anesthesia. Hearing outcomes were further stratified by comparing conventional perforator and Er:YAG laser ablation perforation techniques. Pre- and post-operative audiograms were retrospectively analyzed together with the method of anesthesia and the perforation technique for all patients with otosclerosis who underwent stapedotomy between 1998 and 2007. Pre-operative individual standard audiometry frequency thresholds (IFTs), air (AC) and bone conduction pure tone averages (PTA), and air bone gaps (ABG) were compared against post-operative results. Differences between pre- and post-operative PTAs and ABGs were compared between patients who received stapedotomy under local versus general anesthesia, as well as for patients who underwent conventional versus Er:YAG laser ablation perforations. Eighty-six patients were identified of which 24 % (n = 21) received local and 76 % (n = 65) received general anesthesia. Post-operative audiograms were available for 84 and 48 patients, respectively. Significant improvements were seen across all groups for standard 4-frequency AC-PTA and ABG and for IFTs up to 3 kHz. No significant difference was seen for IFTs between 4 and 6 kHz. A significant decline in post-operative hearing thresholds was seen at 8 kHz. Significant improvements in PTA and ABG were seen for all groups. There was a trend toward general compared to local anesthesia post-operative hearing results furthermore in combination with conventional perforation technique then with laser technique.
AB - Advances in operative technique, instrumentation, and prosthesis design in otosclerosis surgery continue since Shea performed the first successful surgery. This is the first analysis to specifically compare post-operative hearing outcomes following stapedotomy surgery performed under local versus general anesthesia. Hearing outcomes were further stratified by comparing conventional perforator and Er:YAG laser ablation perforation techniques. Pre- and post-operative audiograms were retrospectively analyzed together with the method of anesthesia and the perforation technique for all patients with otosclerosis who underwent stapedotomy between 1998 and 2007. Pre-operative individual standard audiometry frequency thresholds (IFTs), air (AC) and bone conduction pure tone averages (PTA), and air bone gaps (ABG) were compared against post-operative results. Differences between pre- and post-operative PTAs and ABGs were compared between patients who received stapedotomy under local versus general anesthesia, as well as for patients who underwent conventional versus Er:YAG laser ablation perforations. Eighty-six patients were identified of which 24 % (n = 21) received local and 76 % (n = 65) received general anesthesia. Post-operative audiograms were available for 84 and 48 patients, respectively. Significant improvements were seen across all groups for standard 4-frequency AC-PTA and ABG and for IFTs up to 3 kHz. No significant difference was seen for IFTs between 4 and 6 kHz. A significant decline in post-operative hearing thresholds was seen at 8 kHz. Significant improvements in PTA and ABG were seen for all groups. There was a trend toward general compared to local anesthesia post-operative hearing results furthermore in combination with conventional perforation technique then with laser technique.
KW - Adolescent
KW - Adult
KW - Aged
KW - Anesthesia, General
KW - Anesthesia, Local
KW - Audiometry
KW - Child
KW - Female
KW - Hearing
KW - Humans
KW - Lasers, Solid-State
KW - Male
KW - Middle Aged
KW - Otosclerosis
KW - Prosthesis Design
KW - Retrospective Studies
KW - Stapes Surgery
KW - Treatment Outcome
KW - Young Adult
U2 - 10.1007/s00405-014-3014-6
DO - 10.1007/s00405-014-3014-6
M3 - SCORING: Journal article
C2 - 24728229
VL - 272
SP - 2121
EP - 2127
JO - EUR ARCH OTO-RHINO-L
JF - EUR ARCH OTO-RHINO-L
SN - 0937-4477
IS - 9
ER -