Hearing Outcome with the Use of Glass Ionomer Cement as an Alternative to Crimping in Stapedotomy

Objective: To evaluate early hearing outcomes using glass ionomer cement to fix the Teflon piston prosthesis onto the long process of incus to minimize residual conductive hearing loss after stapedotomy. Study Design: Original report of prospective randomized control study. Setting: Tertiary referral center. Patients: A total of 80 consecutive patients with otosclerosis were randomized into two groups. Group A is a control group in which 40 patients underwent small fenestra stapedotomy using the classic technique. Group B included 40 patients who were subjected to small fenestra stapedotomy with fixation of the incus-prosthesis junction with glass ionomer bone cement. Interventions: Stapedotomy with the classical technique in group A and the alternative technique in group B. Primary Outcome Measure: The audiometric results before and after surgery. Results: Analysis of the results was performed using the paired t test to compare between pre and postoperative results. χ2 test was used to compare the results of the two groups. A p value less than 0.05 was considered significant from the statistical standpoint. Significant postoperative improvement of both pure-tone air conduction thresholds and air-bone gaps were reported in the two studied groups. The postoperative average residual air-bone gap and hearing gain were statistically significant in group B (p < 0.05) compared with group A. Conclusion: The use of glass ionomer bone cement in primary otosclerosis surgery using the aforementioned prosthesis and the surgical technique is of significant value in producing maximal closure of the air-bone gap and better audiological outcomes.