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. 2022 Oct;42(5):471-480.
doi: 10.14639/0392-100X-N2033.

Hearing outcomes and patient satisfaction after stapes surgery: local versus general anaesthesia

Beatrice Giannoni  1   2 , Federica Pollastri  1   2 , Chiara Adembri  3 , Dina Straticò  1 , Paolo Vannucchi  1 , Alessia Stival  1 , Curzio Checcucci  4 , Chiara Bruno  5 , Rudi Pecci  1
Affiliations

Hearing outcomes and patient satisfaction after stapes surgery: local versus general anaesthesia

Beatrice Giannoni et al. Acta Otorhinolaryngol Ital. 2022 Oct.

Abstract
in English, Italian

Objective: Otosclerosis is a frequent ear disorder causing a stapedo-ovalar ankylosis and conductive hearing loss. Stapedoplasty, performed under both general (GA) and local anaesthesia (LA), is the most advisable surgical solution. Auditory recovery relies on the patient's conditions and on the intervention itself. The aim of our work was to compare hearing outcomes with stapedoplasty performed under GA or LA and to investigate patients' compliance to both methods.

Methods: Fifty-five otosclerotic patients underwent stapedoplasty both under GA (32/55) and LA (23/55). Pre- and post-operative air and bone tone audiometry threshold values as well as the air-bone gap and its closure score, were analysed. All patients filled in a satisfaction questionnaire regarding their concern and level of appreciation of the type of anaesthesia.

Results and conclusions: Our data show that the auditory results with stapedoplasty are good and do not differ between LA and GA. Even considering the advantages and limits of the two methods, one cannot favour one or the other type of anaesthesia. Finally, the patient's satisfaction cannot be considered a criterion of choice, since this was found to be high in both cases.

Risultati uditivi e gradimento nei pazienti operati di stapedoplastica in anestesia locale e generale.

Obiettivo: L’otosclerosi è una frequente patologia otologica che provoca anchilosi stapedo-ovalare e ipoacusia trasmissiva. La stapedoplastica, eseguita in anestesia generale (AG) o locale (AL), è la soluzione chirurgica ideale. Il recupero uditivo dipende da variabili legate al paziente e all’intervento. Scopo del nostro lavoro è stato confrontare i risultati uditivi dopo stapedoplastica eseguita in AG e AL e indagare il grado di soddisfazione dei pazienti nei riguardi delle due metodiche.

Metodi: Abbiamo studiato 55 pazienti con otosclerosi sottoposti a stapedoplastica in AG (32/55) e AL (23/55). Abbiamo valutato la soglia audiometrica tonale pre- e post-operatoria, il valore del gap trasmissivo via aerea-ossea e la sua chiusura. I pazienti hanno compilato un questionario di soddisfazione riguardo alla preoccupazione e al livello di apprezzamento del tipo di anestesia.

Risultati e conclusioni: I nostri dati mostrano che i risultati uditivi dopo stapedoplastica sono buoni e non differiscono in base al tipo di anestesia. Anche considerando i vantaggi e i limiti delle due metodiche non si può propendere per la scelta dell’uno o dell’altro tipo di anestesia. Infine, la soddisfazione del paziente non può essere considerata un criterio di scelta, poiché questa è risultata elevata in entrambi i casi.

Keywords: general anaesthesia; local anaesthesia; otosclerosis; stapedoplasty; stapes surgery.

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Figures

Figure 1.
Figure 1.
AC PTA values in dB, before (abscissae) and after surgery (ordinates). Density of values is greater under the bisector on the right: higher values were registered for pre-operative PTA. The inclination of the regression line highlights the relationship between the two parameters.
Figure 2.
Figure 2.
BC PTA values in dB, before (abscissae) and after surgery (ordinates). The concentrated values on the bisector report a weak variation after surgery.
Figure 3.
Figure 3.
ABG value distribution after surgery in the GA and LA groups.
Figure 4.
Figure 4.
ABG before and after surgery in dB.
See this image and copyright information in PMC

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