{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:38:34Z","timestamp":1791988714020,"version":"4.4.0"},"reference-count":13,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Besides classical stapedotomy, reverse stapedotomy has been used for many years in the management of otosclerosis. Our study aims to investigate whether reversing the surgical steps in stapedotomy impacts vestibular function and hearing improvement. Materials and Methods: A cohort of 123 patients underwent either classic or reverse stapedotomy procedures utilizing a fiber\u2013optic argon laser. Audiological assessments, following the guidelines of the Committee on Hearing and Equilibrium, were conducted, including pure tone average, air\u2013bone (AB) gap, overclosure, and AB gap closure. Vestibular evaluation involved pre- and postoperative comparison of rotatory test parameters, including frequency, amplitude, and slow phase velocity of nystagmus. Results: The study demonstrated an overall median overclosure of 3.3 (3.3, 5.0) dB and a mean AB gap closure of 20.3 \u00b1 8.8 dB. Postoperative median AB gap was 7.5 (7.5, 11.3) dB in the reverse stapedotomy group and 10.0 (10.0, 12.5) dB in the classic stapedotomy group. While overclosure and AB gap closure were marginally superior in the reverse stapedotomy group, these differences did not reach statistical significance. No significant disparities were observed in the frequency, slow phase velocity, or amplitude of nystagmus in the rotational test. Conclusions: Although not always possible, reverse stapedotomy proved to be a safe surgical technique regarding postoperative outcomes. Its adoption may mitigate risks associated with floating footplate, sensorineural hearing loss, and incus luxation\/subluxation, while facilitating the learning curve for less experienced ear surgeons.<\/jats:p>","DOI":"10.3390\/medicina60050803","type":"journal-article","created":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T10:26:36Z","timestamp":1715682396000},"page":"803","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Audiometric and Vestibular Function after Classic and Reverse Stapedotomy"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5941-6057","authenticated-orcid":false,"given":"Janez","family":"Rebol","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia"},{"name":"Faculty of Medicine, University of Maribor, Taborska Ulica 8, 2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7872-586X","authenticated-orcid":false,"given":"Petra","family":"Povalej Br\u017ean","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Maribor, Taborska Ulica 8, 2000 Maribor, Slovenia"},{"name":"Faculty of Electrical Engineering and Computer Science, University of Maribor, Koroska Cesta 46, 2000 Maribor, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S0030-6665(20)30813-6","article-title":"Histopathology of otosclerosis","volume":"26","author":"Linthicum","year":"1993","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.otc.2017.11.001","article-title":"Otosclerosis: Temporal bone pathology","volume":"51","author":"Quesnel","year":"2018","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_3","first-page":"S2","article-title":"A Personal History of Stapedectomy","volume":"19","author":"Shea","year":"1998","journal-title":"Am. J. Otol."},{"key":"ref_4","first-page":"112","article-title":"Stapedotomy versus stapedectomy","volume":"4","author":"Fisch","year":"1982","journal-title":"Am. J. Otol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1111\/j.1749-4486.2008.01707.x","article-title":"Reversal of the steps stapedotomy technique with early removal of the posterior crus: Early posoperative results: How we do it","volume":"33","author":"Fiorino","year":"2008","journal-title":"Clin. Otolaryngol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Comittee on Hearng and Equilibrium (1995). Comittee on Hearing and Equilibrium guidelines for the evaluation of rasults of treatment of conductive hearing loss. Otolaryngol. Head Neck Surg., 113, 186\u2013187.","DOI":"10.1016\/S0194-5998(95)70103-6"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.anl.2007.04.007","article-title":"An analysis of the air-bone gap closure obtained by a crimping and a non-crimping titanium stapes prosthesis in otosclerosis","volume":"35","author":"Tange","year":"2008","journal-title":"Auris Nasus Larynx"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1097\/MAO.0b013e31823e28cb","article-title":"Clinical evaluation of the NiTiBOND stapes prosthesis, an optimized shape memory alloy design","volume":"33","author":"Huber","year":"2012","journal-title":"Otol. Neurotol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1002\/lio2.675","article-title":"Evaluating hearing results in stapedotomy: Comparison of fluoroplastic Causse loop piston and Matrix prosthesis","volume":"6","author":"Faramarzi","year":"2021","journal-title":"Laryngoscope Investig. Otolaryngol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/01.mao.0000247815.23948.89","article-title":"The influence of the sequence of surgical steps on complications rate in stapedotomy","volume":"28","author":"Szymanski","year":"2007","journal-title":"Otol. Neurotol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1097\/MAO.0b013e3182a473eb","article-title":"Factors affecting fenestration of the footplate in stapes surgery: Effectiveness of Fisch\u2019s reversal steps stapedotomy","volume":"34","author":"Ueda","year":"2013","journal-title":"Otol. Neurotol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1097\/MAO.0000000000001475","article-title":"How to avoid a learning curve in stapedotomy: A standardized surgical technique","volume":"38","author":"Kwok","year":"2017","journal-title":"Otol. Neurotol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.1055\/s-2000-15920","article-title":"Fortschritte in der Stapeschirurgie","volume":"79","author":"Hausler","year":"2000","journal-title":"Laryngo-Rhino-Otol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/5\/803\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:41:30Z","timestamp":1760107290000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/5\/803"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,13]]},"references-count":13,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["medicina60050803"],"URL":"https:\/\/doi.org\/10.3390\/medicina60050803","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,13]]}}}