gms | German Medical Science

Background: During the last centuries surgical experience has developed with a wide range of stapes prosthesis for otosclerosis surgery. The incus stapedotomy proposed by Fish became accepted as the standard procedure. Thereby the postoperative hearing benefit depends on a lot of influencing factors like the operation method, the kind of used prosthesis and the perfusion technique. For the first time the effect on the postoperative hearing benefit after local anesthesia and after general anesthesia as another presumable influencing factor was examined.

Methods: In a retrospective clinical study the pre- and postoperative hearing result after incus stapedotomy implanted in 24% in local anesthesia and in 76% in general anesthesia was analysed in 85 patients. The examinated data was based on the pre- and postoperative audiometric test results till 78 months after operation procedure. Not only audiometric test frequency series but also single frequencies concerning both air and bone conduction were measured. A postoperative sound conduction gap of < 10 dB was used as the extent of hearing benefit.

Results: In the general anesthesia group there could have been achieved better components of sound conduction in comparison to the group undergoing local anesthesia (p≥0,05). Concerning the bone conduction only marginal benefit in the lower frequencies was gained in the general anesthesia group. The combination of general anesthesia and conventional perfusion technique surmounted the combination of general anesthesia and laser technique in all combinations of frequencies.

Conclusion: Using general anesthesia in comparison to local anesthesia the postoperative hearing benefit after incus stapedotomy tends to be superior in all audiometric test frequency series.