{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T14:37:56Z","timestamp":1771511876538,"version":"3.50.1"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T00:00:00Z","timestamp":1614038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The aim of this study was to evaluate whether surgeons\u00b4 experience and perioperative single-shot antibiotic prophylaxis affect outcome of patients undergoing stapes surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Patients and methods<\/jats:title>\n<jats:p>We retrospectively evaluated audiological outcomes and postoperative complications of 538 consecutive patients who underwent stapes surgery at a single tertiary referral center between 1990 and 2017. Effects of different clinical variables, including single-shot antibiotic prophylaxis and surgeons\u2019 experience on outcome were assessed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>538 patients underwent 667 stapedotomies and postoperative complication rate was 7.5% (n = 50). Air conduction and air-bone gap closure improved significantly after surgery (14.2 \u00b1 14.8 dB, p = 0.001; 14.5 \u00b1 12.8 dB, p = 0.001). Multivariate analysis revealed that 6 years or less of surgical experience was independently associated with a higher incidence of persisting or recurrent conductive hearing loss (p = 0.033, OR 5.13) but perioperative application of antibiotics had no significant effect on outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>First, clinical outcome regarding persisting or recurrent conductive hearing loss caused by incus necrosis and prosthesis luxation is linked to surgical performance. This underlines the need for a meticulous training and supervision of less experienced surgeons performing stapes surgery. Second, our results do not support the need for perioperative antibiotic prophylaxis in stapes surgery. Potential standard limitations of retrospective cohort studies (selection bias, confusion bias etc.) could play a role in interpreting our results. However, the probability for these limitations is minimized due to the large patient sample.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0247451","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T19:48:53Z","timestamp":1614109733000},"page":"e0247451","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of surgeons\u2019 experience and the single-shot perioperative antibiotic prophylaxis on outcome in stapedotomy"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0770-6677","authenticated-orcid":true,"given":"Faris F.","family":"Brkic","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boban M.","family":"Erovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arina","family":"Onoprienko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Janik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Riss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Lill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Grasl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jafar-Sasan","family":"Hamzavi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erich","family":"Vyskocil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,2,23]]},"reference":[{"issue":"1","key":"pone.0247451.ref001","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1002\/lary.25408","article-title":"A 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otosclerosis with two kinds of prosthesis in residency training","volume":"74","author":"C Dall Igna","year":"2008","journal-title":"Braz J Otorhinolaryngol"},{"issue":"6","key":"pone.0247451.ref008","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1177\/0145561319853520","article-title":"Antibiotic Prophylaxis in Clean Head and Neck Surgery: An Observational Retrospective Single-Centre Study","volume":"98","author":"CM Chiesa-Estomba","year":"2019","journal-title":"Ear Nose Throat J"},{"issue":"10","key":"pone.0247451.ref009","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1002\/lary.26192","article-title":"Efficacy of antibiotic prophylaxis prior to tympanoplasty for contaminated cholesteatoma","volume":"126","author":"NE Pierce","year":"2016","journal-title":"Laryngoscope"},{"issue":"5","key":"pone.0247451.ref010","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1177\/0194599817753610","article-title":"Evidence-Based Use of Perioperative Antibiotics in Otolaryngology","volume":"158","author":"PN Patel","year":"2018","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"3","key":"pone.0247451.ref011","first-page":"CD003996","article-title":"Antibiotic prophylaxis in clean and clean-contaminated ear surgery","author":"HP Verschuur","year":"2004","journal-title":"Cochrane Database Syst Rev"},{"issue":"9","key":"pone.0247451.ref012","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1089\/end.2017.0085","article-title":"Assessing the Impact of Surgeon Experience on Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy: Results of Four High-Volume Surgeons","volume":"31","author":"N Fossati","year":"2017","journal-title":"J Endourol"},{"issue":"5","key":"pone.0247451.ref013","doi-asserted-by":"crossref","first-page":"1177","DOI":"10.11607\/jomi.7480","article-title":"Influence of surgeon experience on the accuracy of implant placement via a partially computer-guided surgical protocol","volume":"34","author":"HF 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