A Retrospective Comparative Study on Use of Slow Speed Micro Drill Versus Hand Held Micro Burr Drill for Stapedotomy in Otosclerosis Patients

  • Pingili Harish Chandra Reddy Associate Professor, Department of ENT
  • K Kamreddy Ashok Reddy Associate Professor of ENT
Keywords: Hearing loss, Micro drill, Otosclerosis, Stapedotomy, Stapes

Abstract

Background: Stapedotomy is the standard procedure adopted in the surgical treatment of otosclerosis. In spite of advanced methods like laser being used in higher centers, handheld burr and low-speed drill remain the choice of method for the beginners.
Aim of the Study: The aim of this study is to compare the two methods of stapedotomy: Handheld burr and slow-speed drill in stapedotomy in terms of results and complications.
Materials and Methods: A retrospective study of 68 stapedotomy procedures performed in the past 6 years was reviewed. Both handheld burr and slow speed micro drill were used in creating stapedotomy. Post-operative evaluation was done using audiometric results (air-bone gap closure and pure tone audiogram). The immediate and late complications were noted and analyzed. In Group A, slow-speed drill was used to cut the posterior crus of stapes as close to the footplate as possible. Fenestration is made in the central area of the footplate using the micro drill. In Group B, handheld 0.2 mm burr was used to drill an initial hole followed by enlargement using a right-angled pick. In both the groups, appropriate size Teflon piston was used.
Conclusions: There was no statistical significant difference in the auditory gain in both the groups. Both procedures were safe for stapedotomy and the natures of complications were similar and manageable without permanent long-term effects.

Author Biographies

Pingili Harish Chandra Reddy, Associate Professor, Department of ENT

Government Medical College, Nizamabad, Telangana, India

K Kamreddy Ashok Reddy, Associate Professor of ENT

Government Medical College, Siddipet, Telangana, India

References

1. Shea JJ. Fenestration of the oval window. Ann Otol Rhinol Laryngol
1958;67:932-51.
2. Perkins RC. Laser stapedotomy for otosclerosis. Laryngoscope
1980;90:228-41.
3. Lesinski SG, Palmer A. Lasers for otosclerosis: CO2 vs. argon and KTP-
532. Laryngoscope 1989;99 Suppl 46;1-8.
4. McGee TM. The argon laser in surgery for chronic ear disease and
otosclerosis. Laryngoscope 1983;93:1177-82.
5. Gjuric M. Microdrill versus perforator for stapedotomy. Clin Otolaryngol
Allied Sci 1990;15:411-3.
6. Sedwick JD, Louden CL, Shelton C. Stapedectomy vs stapedotomy. do you
really need a laser? Arch Otolaryngol Head Neck Surg 1997;123:177-80.
7. Somers T, Vercruysse JP, Zarowski A, Verstreken M, Offeciers E.
Stapedotomy with microdrill or carbon dioxide laser: Influence on inner ear
function. Ann Otol Rhinol Laryngol 2006;115:880-5.
8. Brace C, Keil I, Schwitulla J, Mantsopoulos K, Schmid M, Iro H, et al.
Bone conduction after stapes surgery: Comparison of CO2 laser and manual
perforator. Otol Neurotol 2013;34:821-6.
9. Yavuz H, Caylakli F, Ozer F, Ozluoglu LN. Reliability of microdrill
stapedotomy: Comparison with pick stapedotomy. Otol Neurotol
2007;28:998-1001.
10. Cuda D, Murri A, Mochi P, Solenghi T, Tinelli N. Microdrill, CO2-laser,
and piezoelectric stapedotomy: A comparative study. Otol Neurotol
2009;30:1111-5.
11. Palva T. Argon laser in otosclerosis surgery Acta Otolaryngol
1987;104:153-7.
12. Rothbaum DL, Roy J, Hager GD, Taylor RH, Whitcomb LL,
Francis HW, et al. Task performance in stapedectomy: Comparison
between surgeons of different experience levels. Otolaryngol Head
Neck Surg 2003;128:71-7.
13. Mathews SB, Rasgon BM, Byl FM. Stapes surgery in a residency training
program. Laryngoscope 1999;109:52-3.
14. Mangham CA Jr. Reducing footplate complications in small fenestra
microdrill stapedotomy. Am J Otol 1993;14:118-21.
15. Barbara M, Monini S, de Seta E, Filipo R. Early hearing evaluation after
microdrill stapedotomy. Clin Otolaryngol Allied Sci 1994;19:9-12.
Published
2021-10-05