Objective: The aim of this study is to perform a systematic literature review on the occurrence of gusher during stapes surgery, to understand its surgical management and outcomes. Methods: The PRISMA standard was applied to identify English, Italian or French-language studies, related to stapes surgery and mentioning gusher or perilymphatic leak. Full-texts lacking information on the management of gusher and/or the post-operative hearing outcome were excluded. Results: Twenty-four articles were eventually included. Seventy-six patients were involved in the qualitative synthesis. The management of gusher mostly consisted in covering the oval window and/or filling the tympanic cavity, with absorbable and autologous graft materials. Packing of the external auditory canal was reported in 51 patients (67%). Gusher was related to complete/profound loss of hearing in 25% of the cases and to a worsening of hearing function in 31% of patients. In 19% of patients an improvement in hearing tests was reported; in 28% the hearing function was unchanged. Post-operative vestibular symptoms were reported in 7 patients, and were mainly mild and transient. The absence of vestibular symptoms was underlined in 9 cases, while in 79% of the patients the authors did not provide information. Conclusion: The unexpected occurrence of gusher during stapes surgery represents a relevant issue for the otologic surgeon. Its management most commonly consists in plugging the oval window and the tympanic cavity. In most of the cases, a stapes prosthesis could be positioned. The results on hearing and vestibular functions are widely variable.
Gusher in stapes surgery: a systematic review / Alicandri-Ciufelli, M.; Molinari, G.; Rosa, M. S.; Monzani, D.; Presutti, L.. - In: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY. - ISSN 0937-4477. - 276:9(2019), pp. 2363-2376.
|Data di pubblicazione:||2019|
|Data di prima pubblicazione:||4-lug-2019|
|Titolo:||Gusher in stapes surgery: a systematic review|
|Autore/i:||Alicandri-Ciufelli, M.; Molinari, G.; Rosa, M. S.; Monzani, D.; Presutti, L.|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s00405-019-05538-x|
|Codice identificativo ISI:||WOS:000478901700001|
|Codice identificativo Scopus:||2-s2.0-85068869491|
|Codice identificativo Pubmed:||31273448|
|Citazione:||Gusher in stapes surgery: a systematic review / Alicandri-Ciufelli, M.; Molinari, G.; Rosa, M. S.; Monzani, D.; Presutti, L.. - In: EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY. - ISSN 0937-4477. - 276:9(2019), pp. 2363-2376.|
|Tipologia||Articolo su rivista|
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