ReviewEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Reversal versus classic stapedotomy for otosclerosis: a systematic review and meta-analysis.
Review in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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Abstract
backgroundStapedotomy is the standard surgical intervention for otosclerosis, but the optimal sequence of surgical steps remains debated. This systematic review and meta-analysis aims to compare the efficacy and safety of reversal versus classic stapedotomy for otosclerosis.
methodsA comprehensive search across five databases was conducted up to February 2026 for randomized controlled trials (RCTs) and non-randomized studies (NRS). The primary outcome was audiological success, defined as air-bone gap (ABG) closure to ≤ 10 dB. Secondary outcomes included continuous audiometric parameters and surgical complications. Risk ratios (RRs) and mean differences (MDs) were pooled using a random-effects model.
resultsTen studies (2 RCTs, 8 NRS) involving 1,540 patients were included. There was no significant difference between the reversal and classic techniques in achieving an ABG ≤ 10 dB (RR: 1.02, 95% CI [0.93, 1.13]). While statistically significant differences favored the reversal approach for postoperative ABG (MD: -1.57 dB, 95% CI [- 2.59, - 0.54]) and postoperative air conduction pure-tone average (MD: -1.86 dB, 95% CI [- 3.17, - 0.55]), these differences lacked clinical significance. Regarding safety, no statistically significant differences were observed, although the reversal approach showed favorable trends toward reduced floating footplates (RR: 0.23, 95% CI [0.04, 1.24]) and chorda tympani injuries (RR: 0.54, 95% CI [0.29, 1.00]).
conclusionReversal and classic stapedotomy demonstrate comparable audiological outcomes, with no statistically significant differences observed in the assessed safety outcomes. However, the certainty of evidence was low for audiological outcomes and very low for complications, precluding definitive conclusions until further large-scale RCTs are available.
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Registered trials
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