A review on reversal stapedotomy outcome and associated factors

Otosclerosis (OS) occurs as a result of impaired bone remodeling in otic capsule (labyrinthine) and stapes footplate which might present clinically in form of conductive hearing loss. Surgical treatment and stapedotomy are the most promising treatment. Fisch, described that the early fenestration in “reversal stapedotomy” reduces the risk of a floating footplate. In this study we evaluated efficacy of reversal stapedotomy technique amongst 74 OS patients and considered associated factors for better assessment. Seventy-four OS patient with mean age of 34.19 ± 9. 07 were studied retrospectively. Subjects had reversal stapedotomy and were followed for 12 months by air-bone gap (ABG) analysis and comparison of pre and post audiometry. Surgical complications, anatomical abnormalities and gender were considered as well. Success rate was near 90% considering ABG of 10 dB or better. There was a significant correlation between ABG and speech reception threshold mean differences. The complications of this technique were not significant except endolymph leakage in 1 case of obliterative OS. The reversal stapedotomy is a safe procedure for treatment of OS with excellent improvement of hearing levels in comparison with other stapes surgery, based on literature review. Those with dehiscent facial nerve benefit less than others.