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Early Postoperative Imaging of the Labyrinth by Cone Beam CT After Stapes Surgery for Otosclerosis With Correlation to Audiovestibular Outcome

Vandevoorde, Aurélie; Williams, Marc T.; Ukkola-Pons, Elsa; Daval, Mary; Ayache, Denis

doi: 10.1097/MAO.0000000000001306

Background: Sensorineural complications of stapes surgery are rare but potentially serious. Imaging is usually performed to identify an underlying cause, such as excessive intravestibular penetration of the prosthesis or pneumolabyrinth suggesting perilymphatic fistula. Unfortunately, there is very little data in an unselected series of uneventful patients.

The aim of this study was to analyze the depth of prosthesis penetration within the vestibule and the rate of pneumolabyrinth the day or the day after the procedure by performing a cone beam computed tomography of the temporal bone in a cohort of unselected patients, and to correlate imaging findings to clinical outcome.

Methods: A prospective monocentric study was conducted in a tertiary referral medical center. A cone beam computed tomography was performed in 80 consecutive patients having undergone stapes surgery for otosclerosis, the day or the day after the procedure. Penetration length and location of the prosthesis within the vestibule, as well as presence or absence of a pneumolabyrinth, were recorded, and compared with clinical data (vertigo, nystagmus, hearing measurement).

Results: Pneumolabyrinth was found in 15% of the patients. The mean penetration length of the prosthesis within the vestibule was 1 mm (0–1.9 mm). No serious complication occurred during the study period. No correlations were found when comparing imaging findings to clinical outcome.

Conclusion: Our results do not support empirically insights into detrimental effects of postoperative pneumolabyrinth or too long prosthesis after stapes surgery. Further studies are needed to better understand the causes of postoperative complications of stapes surgery.

*Department of Otolaryngology, Head and Neck Surgery

Department of Medical Imaging, Fondation A. de Rothschild, Paris, France

Address correspondence and reprint requests to Denis Ayache, M.D., Associate Professor, College of Medicine of Paris Hospitals, Chairman, Department of Otolaryngology, Head and Neck Surgery, Fondation A. de Rothschild, 25-29, rue Manin, 75019 Paris, France; E-mail:

The authors disclose no conflicts of interest.

Copyright © 2017 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company