Section: 
Otiology
OtiologyOptimization of methods of intraoperative and postoperative treatment of patients with otosclerosis after stapedoplasty
M. L. Blinova (1), Yu. K. Yanov (2), A. E. Golovanov (3), V. S. Isachenko (4), V. V. Dvoryanchikov (5)
(1), (3), (4), (5) Saint Petersburg Research Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russian Federation, (2) Kirov Military Medical Academy, Saint Petersburg, 194044, Russian Federation, (4) Medical Institute of Saint Petersburg State University, Saint Petersburg, 199034, Russian Federation
UDK: УДК 616.284-002.2:616.288.5-006.488-089.87:615.849.19
DOI: https://doi.org/10.18692/1810-4800-2025-1-80-90
ABSTRACT
Abstract. Currently, there is an increased interest in the medical community in the problems associated with the occurrence of vestibular and cochlear dysfunctions in the early postoperative period after stapedoplasty. Vestibular dysfunction occurs in 27–37% of cases in the early postoperative period, in 3–4% of cases within a month after surgical treatment, in 25% it is accompanied by impaired balance function. The risk of deafness after stirrup surgery is recorded in 0,9–2% of cases. The purpose of the study. A comparative assessment of the functional results characterizing the condition of the inner ear in patients with otosclerosis in the early postoperative period and in the long term after piston stapedoplasty in one part of cases using a СО2-laser, in the other part of cases of piston stapedoplasty, where perforation in the foot plate of the stirrup was performed with perforators. Comparative assessment of the condition of the cochlear and vestibular systems of the inner ear between groups of patients with otosclerosis in the postoperative period, depending on the method of postoperative treatment, that is, depending on the method of application of glucocorticosteroids — intratipanal or intravenous administration. Patients and methods. 173 patients diagnosed with otosclerosis were examined. Four groups of patients were formed: patients of group I (n = 87) underwent surgery in the volume of piston stapedoplasty, where perforation in the foot plate of the stirrup was performed using a СО2-laser; patients of group II (n = 86) underwent surgery in the volume of piston stapedoplasty using micro-tools and perforators for fenestration of the foot plate of the stirrup. Also, each of the above groups was divided into two subgroups, depending on the method of postoperative management of patients. Results. An assessment is given of the early postoperative and long-term results after piston stapedoplasty using various surgical assistants, namely piston stapedoplasty performed using a СО2-laser and using manual techniques, that is, using micro-tools, including perforators. A method of optimal management of patients in the postoperative period is considered, which makes it possible to shorten the rehabilitation time of patients in the postoperative period, as well as minimize and possibly in some cases prevent the development of cochleovestibular dysfunction.
Publication date:
20.02.2025
Keywords:
otosclerosis, piston stapedoplasty, СО2-laser, cochleovestibular disorders, intrathympanic use of glucocorticosteroids, computer videonystagmography, computer stabilometry For citation:
Blinova M. L., Yanov Yu. K., Golovanov A. E., Isachenko V. S., Dvoryanchikov V. V. Optimization of methods of intraoperative and postoperative treatment of patients with otosclerosis after stapedoplasty. Российская оториноларингология. 2025;24(4):80–90. https://doi.org/10.18692/1810-4800-2025-1-80-90