{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:44:33Z","timestamp":1790390673765,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,6,24]],"date-time":"2015-06-24T00:00:00Z","timestamp":1435104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effect of piston diameter in primary stapedotomy for otosclerosis patients measured by hearing outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Embase, and the Cochrane Library.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>A systematic search was conducted. Studies reporting original data on the effect of piston diameter on pure\u2010tone audiometric results in patients undergoing primary stapedotomy for otosclerosis were included. Relevance and risk of bias of the selected articles were assessed. Studies with low relevance, high risk of bias, or both were excluded. Absolute risks and risk differences, means and mean differences, and 95% confidence intervals were extracted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve studies with moderate to high relevance and moderate risk of bias were included for data extraction. Air\u2010bone gap closure to 10 dB or less was assessed in six studies, the majority of which did not show a statistically significant or clinically relevant difference between two pistons with a different diameter. More importantly, the differences that were found were not consistently in favor of smaller\u2010diameter pistons or larger\u2010diameter pistons. Mean postoperative air\u2010bone gap ranged from 3 dB in favor of a smaller\u2010diameter piston to 3 dB in favor of a larger\u2010diameter piston across four studies. Permanent sensorineural hearing loss was assessed in eight studies and occurred in only one study. In this study, no difference was found between a 0.4\u2010mm\u2010diameter piston and a 0.6\u2010mm\u2010diameter piston.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is not sufficient evidence to support the superiority of the use of a larger\u2010diameter piston compared to a smaller\u2010diameter piston for primary stapedotomy in otosclerosis patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      NA\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 126:182\u2013190, 2016\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.25408","type":"journal-article","created":{"date-parts":[[2015,6,24]],"date-time":"2015-06-24T12:13:21Z","timestamp":1435148001000},"page":"182-190","source":"Crossref","is-referenced-by-count":30,"title":["A systematic review of the effect of piston diameter in stapes surgery for otosclerosis on hearing results"],"prefix":"10.1002","volume":"126","author":[{"given":"Inge","family":"Wegner","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University Medical Center Utrecht, Utrecht  the Netherlands"},{"name":"Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica J.","family":"Verhagen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University Medical Center Utrecht, Utrecht  the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Stegeman","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University Medical Center Utrecht, Utrecht  the Netherlands"},{"name":"Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Vincent","sequence":"additional","affiliation":[{"name":"Causse Ear Clinic Traverse de B\u00e9ziers Colombiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilko","family":"Grolman","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery University Medical Center Utrecht, Utrecht  the Netherlands"},{"name":"Brain Center Rudolf Magnus University Medical Center Utrecht Utrecht the 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