# Stapedotomy Utilizing a Fixed-Size Prosthesis in a Tertiary Care Center: A Retrospective Study

## TL;DR

This study shows that using a standard 4.5 mm prosthesis in stapes surgery leads to successful hearing improvement and few complications.

## Contribution

The study demonstrates that a fixed-size prosthesis can be effective without custom measurements, reducing surgical complexity.

## Key findings

- Mean air-bone gap improved significantly from 27.9 dB preoperatively to 3.95 dB post-operatively.
- 96.96% of ears had a postoperative air-bone gap of ≤10 dB.
- Only minor complications like transient dizziness and one case of reparative granuloma occurred.

## Abstract

Background

Stapes surgery success depends on several factors, including the length of the prosthesis used. Whether to use a standard-size prosthesis or measure the length of the stapes prosthesis has been debated in the literature. This study aims to assess the surgical outcomes of a stapedotomy using the standard 4.5 mm prosthesis without custom measurements.

Methodology

This retrospective study involved patients with otosclerosis who underwent primary stapedotomy using a standardized 4.5 mm fixed-length prosthesis between January 2017 and February 2023 at a tertiary care center.

Results

Out of 111 charts reviewed, 99 ears (56 males and 43 females) were studied. The mean air-bone gap (ABG) significantly improved from 27.9 ± 9.12 dB preoperatively to 3.95 ± 3.54 dB post-operatively (p-value < 0.05). Hearing results showed that out of 99 ears, 96.96% had a postoperative ABG of ≤10 dB and 98.98% ≤20 dB. Only three patients showed postoperative mild transient dizziness that lasted a few days. None of the patients had persistent dizziness for more than one week. One patient developed postoperative reparative granuloma with tinnitus and sensory-neural hearing loss. None had a recurrence of the conductive hearing loss during the study period.

Conclusion

Our retrospective study on stapes surgery utilizing a standardized 4.5 mm prosthesis without custom measurements showed notable surgical success and safety. Using a standard-size prosthesis shortens the surgical time and eliminates the complexities associated with intraoperative measurements, potentially reducing the risk of complications.