Is it safe and effective to perform stapes surgery in Bellucci type 1 chronic otitis media?

Purpose: The study's objective was to evaluate the safety and outcomes of stapes surgery in patients with Bellucci type 1 chronic otitis media.

Methods: The study group was composed of Bellucci type 1 chronic otitis media patients who were found to have stapedial footplate fixation during surgery for chronic otitis media. Stapedotomy and prosthesis insertion were performed during the same operation. The control group consisted of patients with an intact tympanic membrane who underwent stapedotomy for primary otosclerosis. The study and control groups comprised 11 and 16 patients, respectively. No preoperative or intraoperative perforation was present in the control group. We recorded the pre-and post-operative air conduction thresholds, the presence and degree of any air-bone gap (ABG) and documented any postoperative complications. A comparison was then made between the two groups.

Results: The mean preoperative air conduction threshold for patients in the study group was 51.73 dBHL, which improved to 33.27 dBHL after surgery. In the control group, the preoperative mean air conduction threshold was 50.13 dB HL, which also demonstrated significant improvement postoperatively, with a threshold of 29.5 dB HL. Preoperative ABG was 31.36 dBHL and 29.88 dBHL, respectively, in the study and control group. Postoperatively, ABG was reduced to 14.82 dBHL and 10.06dBHL in the study and control groups, respectively (p < 0.001).

Conclusion: The preliminary findings of the present study indicated that concurrent tympanoplasty and stapedotomy in Bellucci type 1 chronic otitis media patients could yield safe and effective outcomes. Further investigations should be conducted to set forth the benefits of a single-stage surgery over a series of staged surgeries.