Skip to main content Accessibility help
×
Home

Reporting in stapes surgery: are we following the guidelines?

  • G J Watson (a1) and M da Cruz (a2)

Abstract

Objective

This paper highlights the importance of reporting air–bone gap closure in stapes surgery according to the American Academy of Otolaryngology – Head and Neck Surgery guidelines and reviews compliance in recent years.

Methods

A retrospective case series was conducted and the outcomes were reviewed. Closure of the air–bone gap was calculated in 204 adult patients using the aforementioned guidelines. Results were recalculated ignoring the Carhart phenomenon to determine any significant difference. Adherence to guidelines was also reported as a secondary outcome.

Results

Ignoring the Carhart phenomenon resulted in 75 per cent over-reporting of successful air–bone gap closure (p < 0.001). Over-reporting occurred in 5.9 per cent of papers, and in 11.8 per cent it was difficult to determine how the results were reached.

Conclusion

Despite the existence of clear guidelines, stapes surgery outcomes are still being over-reported as successful. This can lead to incorrect information being provided to patients during the consent process and makes comparative studies difficult.

Copyright

Corresponding author

Address for correspondence: Mr G J Watson, Department of Otolaryngology – Head and Neck Surgery, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK E-mail: glen.watson@sth.nhs.uk

Footnotes

Hide All

Mr G J Watson takes responsibility for the integrity of the content of the paper

Footnotes

References

Hide All
1American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. Otolaryngol Head Neck Surg 1995;113:186–7
2Carhart, R. Clinical application of bone conduction audiometry. Arch Otolaryngol 1950;51:798808
3Gatehouse, S, Browning, GG. A re-examination of the Carhart effect. Br J Audiol 1982;16:215–20
4Badran, K, Gosh, S, Farag, A, Timms, MS. How we do it: switching from mechanical perforation to the CO2 laser; audit results of primary small-fenestra stapedotomy in a district general hospital. Clin Otolaryngol 2006;3:546–9
5Berliner, KI, Doyle, KJ, Goldenberg, RA. Reporting operative hearing results in stapes surgery: does choice of outcome measure make a difference? Am J Otol 1996;17:214–20
6Fiorino, F, Barbieri, F. Reversal of the steps stapedotomy technique with early removal of the posterior crus: early postoperative results: how we do it. Clin Otolaryngol 2008;33:359–62
7Gerlinger, I, Toth, M, Bako, P, Nemeth, A, Pytel, J. KTP-laser stapedotomy with a self-crimping, thermal shape memory Nitinol SMart piston: 1 year follow-up results: how we do it. Clin Otolaryngol 2008;33:475–80
8Banerjee, A, Hawthorne, MR, Flood, LM, Martin, FW. Audit of stapedectomy results in a district general hospital. Clin Otolaryngol 2002;27:275–8
9Berenholz, L, Lippy, W, Harell, M. Revision stapedectomy in Israel. Otol Neurotol 2002;23:850–3
10Daniels, RL, Krieger, LW, Lippy, WH. The other ear: findings and results in 1,800 bilateral stapedectomies. Otol Neurotol 2001;22:603–7
11De La Cruz, A, Fayad, JN. Revision stapedectomy. Otolaryngol Head Neck Surg 2000;123:728–32
12Lippy, WH, Battista, RA, Berenholz, L, Schuring, AG, Burkey, JM. Twenty-year review of revision stapedectomy. Otol Neurotol 2003;24:560–6
13Lippy, WH, Wingate, J, Burkey, JM, Rizer, FM, Schuring, AG. Stapedectomy revision in elderly patients. Laryngoscope 2002;112:1100–3
14Acar, GO, Kivekas, I, Hanna, BM, Huang, L, Gopen, Q, Poe, DS. Comparison of stapedotomy minus prosthesis, circumferential stapes mobilization, and small fenestra stapedotomy for stapes fixation. Otol Neurotol 2014;35:e1239
15Arnoldner, C, Schwab, B, Lenarz, T. Clinical results after stapedotomy: a comparison between the erbium: yttrium-aluminum-garnet laser and the conventional technique. Otol Neurotol 2006;27:458–65
16Bauer, M, Pytel, J, Vona, I, Gerlinger, I. Long-term results of the use of autogenous cortical bone columellas to replace the stapes at stapedectomy. Eur Arch Otorhinolaryngol 2011;268:671–5
17Bittermann, AJ, Vincent, R, Rovers, MM, van der Heijden, GJ, Tange, RA, Dreschler, WA et al. A nonrandomized comparison of stapes surgery with and without a vein graft in patients with otosclerosis. Otol Neurotol 2013;34:827–31
18Brase, C, Schwitulla, J, Kunzel, J, Meusel, T, Iro, H, Hornung, J. First experience with the fiber-enabled CO2 laser in stapes surgery and a comparison with the “one-shot” technique. Otol Neurotol 2013;34:1581–5
19Brown, KD, Gantz, BJ. Hearing results after stapedotomy with a nitinol piston prosthesis. Arch Otolaryngol Head Neck Surg 2007;133:758–62
20Fayad, JN, Semaan, MT, Meier, JC, House, JW. Hearing results using the SMart piston prosthesis. Otol Neurotol 2009;30:1122–7
21Galli, J, Parrilla, C, Fiorita, A, Marchese, MR, Paludetti, G. Erbium: yttrium-aluminum-garnet laser application in stapedotomy. Otolaryngol Head Neck Surg 2005;133:923–8
22Gerard, JM, Serry, P, Gersdorff, MC. Outcome and lack of prognostic factors in stapes surgery. Otol Neurotol 2008;29:290–4
23Harris, JP, Gong, S. Comparison of hearing results of nitinol SMART stapes piston prosthesis with conventional piston prostheses: postoperative results of nitinol stapes prosthesis. Otol Neurotol 2007;28:692–5
24Hazenberg, AJ, Minovi, A, Dazert, S, Hoppe, FF. Predictors of listening capabilities and patient satisfaction after stapes surgery in otosclerosis. Otol Neurotol 2013;34:220–6
25Javed, F, Leong, AC, Fairley, JW. Superficial temporal vein graft in stapedotomy: a functional and aesthetic alternative. Clin Otolaryngol 2008;33:120–3.
26Kisilevsky, VE, Bailie, NA, Dutt, SN, Halik, JJ. Functional results of 394 bilateral stapedotomies evaluated with the Glasgow Benefit Plot. Eur Arch Otorhinolaryngol 2010;267:1027–34
27Kojima, H, Komori, M, Chikazawa, S, Yaguchi, Y, Yamamoto, K, Chujo, K et al. Comparison between endoscopic and microscopic stapes surgery. Laryngoscope 2014;124:266–71
28Lippy, WH, Burkey, JM, Schuring, AG, Berenholz, LP. Comparison of titanium and Robinson stainless steel stapes piston prostheses. Otol Neurotol 2005;26:874–7
29Mangham, CA Jr. Nitinol-teflon stapes prosthesis improves low-frequency hearing results after stapedotomy. Otol Neurotol 2010;31:1022–6
30Marchese, MR, Cianfrone, F, Passali, GC, Paludetti, G. Hearing results after stapedotomy: role of the prosthesis diameter. Audiol Neurootol 2007;12:221–5
31Marchese, MR, Scorpecci, A, Cianfrone, F, Paludetti, G. “One-shot” CO2 versus Er:YAG laser stapedotomy: is the outcome the same? Eur Arch Otorhinolaryngol 2011;268:351–6
32Massey, BL, Kennedy, RJ, Shelton, C. Stapedectomy outcomes: titanium versus teflon wire prosthesis. Laryngoscope 2005;115:249–52
33Parrilla, C, Galli, J, Fetoni, AR, Rigante, M, Paludetti, G. Erbium: yttrium-aluminum-garnet laser stapedotomy--a safe technique. Otolaryngol Head Neck Surg 2008;138:507–12
34Quaranta, N, Besozzi, G, Fallacara, RA, Quaranta, A. Air and bone conduction change after stapedotomy and partial stapedectomy for otosclerosis. Otolaryngol Head Neck Surg 2005;133:116–20
35Rajan, GP, Atlas, MD, Subramaniam, K, Eikelboom, RH. Eliminating the limitations of manual crimping in stapes surgery? A preliminary trial with the shape memory Nitinol stapes piston. Laryngoscope 2005;115:366–9.
36Rajan, GP, Diaz, J, Blackham, R, Eikelboom, RH, Atlas, MD, Shelton, C et al. Eliminating the limitations of manual crimping in stapes surgery: mid-term results of 90 patients in the Nitinol stapes piston multicenter trial. Laryngoscope 2007;117:1236–9
37Redfors, YD, Moller, C. Otosclerosis: thirty-year follow-up after surgery. Ann Otol Rhinol Laryngol 2011;120:608–14
38Roosli, C, Huber, AM. Mid-term results after a newly designed nitinol stapes prosthesis use in 46 patients. Otol Neurotol 2013;34:e614
39Sarac, S, McKenna, MJ, Mikulec, AA, Rauch, SD, Nadol, JB Jr, Merchant, SN. Results after revision stapedectomy with malleus grip prosthesis. Ann Otol Rhinol Laryngol 2006;115:317–22
40Satar, B, Sen, D, Karahatay, S, Birkent, H, Yetiser, S. Effect of cochlear reserve on postoperative outcome in otosclerosis. Eur Arch Otorhinolaryngol 2007;264:489–93
41Schmid, P, Hausler, R. Revision stapedectomy: an analysis of 201 operations. Otol Neurotol 2009;30:1092–100
42Sorom, AJ, Driscoll, CL, Beatty, CW, Lundy, L. Retrospective analysis of outcomes after stapedotomy with implantation of a self-crimping Nitinol stapes prosthesis. Otolaryngol Head Neck Surg 2007;137:65–9
43Stucken, EZ, Brown, KD, Selesnick, SH. The use of KTP laser in revision stapedectomy. Otol Neurotol 2011;33:1297–9
44Szyfter, W, Mielcarek-Kuchta, D, Mietkiewska-Leszniewska, D, Mlodkowska, A, Laczkowska-Przybylska, J. Comparison between 2 laser systems, Er-Yag and CO2, in stapes surgery. Otol Neurotol 2013;34:2935
45Tenney, J, Arriaga, MA, Chen, DA, Arriaga, R. Enhanced hearing in heat-activated-crimping prosthesis stapedectomy. Otolaryngol Head Neck Surg 2008;138:513–17
46Ueda, H, Kishimoto, M, Uchida, Y, Sone, M. Factors affecting fenestration of the footplate in stapes surgery: effectiveness of Fisch's reversal steps stapedotomy. Otol Neurotol 2013;34:1576–80
47Van Rompaey, V, Claes, G, Somers, T, Offeciers, E. Erosion of the long process of the incus in revision stapes surgery: malleovestibular prosthesis or incus reconstruction with hydroxyapatite bone cement? Otol Neurotol 2011;32:914–18
48Vincent, R, Bittermann, AJ, Oates, J, Sperling, N, Grolman, W. KTP versus CO2 laser fiber stapedotomy for primary otosclerosis: results of a new comparative series with the otology-neurotology database. Otol Neurotol 2013;33:928–33
49Vincent, R, Grolman, W, Oates, J, Sperling, N, Rovers, M. A nonrandomized comparison of potassium titanyl phosphate and CO2 laser fiber stapedotomy for primary otosclerosis with the otology-neurotology database. Laryngoscope 2010;120:570–5
50Vincent, R, Rovers, M, Zingade, N, Oates, J, Sperling, N, Deveze, A et al. Revision stapedotomy: operative findings and hearing results. A prospective study of 652 cases from the Otology-Neurotology Database. Otol Neurotol 2010;3:875–82
51Wiet, RJ, Battista, RA, Wiet, RM, Sabin, AT. Hearing outcomes in stapes surgery: a comparison of fat, fascia, and vein tissue seals. Otolaryngol Head Neck Surg 2013;148:115–20
52Cuda, D, Murri, A, Mochi, P, Solenghi, T, Tinelli, N. Microdrill, CO2-laser, and piezoelectric stapedotomy: a comparative study. Otol Neurotol 2009;30:1111–15
53Pudel, EI, Briggs, RJ. Laser-assisted stapedotomy with a Nitinol heat-crimping prosthesis: outcomes compared with a platinum fluoroplastic prosthesis. Otolaryngol Head Neck Surg 2008;139:51–4
54Shine, NP, Rodrigues, S, Miller, S, Packer, P. Bilateral stapedectomy: association between first- and second-ear surgical findings and their effects on the second-ear outcome. Ann Otol Rhinol Laryngol 2008;117:207–11
55Albers, AE, Schonfeld, U, Kandilakis, K, Jovanovic, S. CO(2) laser revision stapedotomy. Laryngoscope 2013;123:1519–26
56Felix-Trujillo, MM, Valdez-Martinez, E, Ramirez, JE, Lozano-Morales, R. Surgical and medical treatment of hearing loss in mixed otosclerosis. Ann Otol Rhinol Laryngol 2009;118:859–65
57Gouveris, H, Toth, M, Koutsimpelas, D, Schmidtmann, I, Mann, WJ. Short-term hearing results after primary stapedotomy with nitinol and teflon-platinum prostheses for otosclerosis. Eur Arch Otorhinolaryngol 2013;270:2201–5
58Grolman, W, Tange, RA. First experience with a new stapes clip piston in stapedotomy. Otol Neurotol 2005;26:595–8
59Lavy, J, Khalil, S. Five-year hearing results with the shape memory nitinol stapes prosthesis. Laryngoscope 2014;124:2591–3
60Salami, A, Mora, R, Mora, F, Guastini, L, Salzano, FA, Dellepiane, M. Learning curve for Piezosurgery in well-trained otological surgeons. Otolaryngol Head Neck Surg 2010;142:120–5
61Yavuz, H, Caylakli, F, Ozer, F, Ozluoglu, LN. Reliability of microdrill stapedotomy: comparison with pick stapedotomy. Otol Neurotol 2007;28:9981001
62Vincent, R, Gratacap, B, Oates, J, Sperling, NM. Stapedotomy in osteogenesis imperfecta: a prospective study of 23 consecutive cases. Otol Neurotol 2005;26:859–65
63Gurgel, RK, Jackler, RK, Dobie, RA, Popelka, GR. A new standardized format for reporting hearing outcome in clinical trials. Otolaryngol Head Neck Surg 2012;147:803–7

Keywords

Reporting in stapes surgery: are we following the guidelines?

  • G J Watson (a1) and M da Cruz (a2)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed