Local versus general anesthesia in stapes surgery for otosclerosis: a systematic review of the evidence

Otolaryngol Head Neck Surg. 2013 Sep;149(3):360-5. doi: 10.1177/0194599813493393. Epub 2013 Jun 13.


Objective: To assess hearing results following primary stapes surgery in patients with otosclerosis, comparing local and general anesthesia.

Data sources: PubMed, Embase, the Cochrane Library, CINAHL, and Scopus.

Review methods: A systematic search was conducted, followed by assessment of directness of evidence and risk of bias. Studies reporting original data on the effect of local anesthesia, compared to general anesthesia, on closure of air-bone gap in patients undergoing stapes surgery for otosclerosis were included.

Results: A total of 257 unique studies were retrieved, of which 3 (including 417 procedures) satisfied the eligibility criteria. Assessment showed that all studies carried high risk of bias, and only 1 study provided direct evidence.

Conclusion: There is no difference in postoperative air-bone gap, worsening of sensorineural hearing loss, and postoperative vertigo between the 2 groups. A statistically significant increased risk of immediate dead ear following stapes surgery performed under general anesthesia was reported in 1 study.

Keywords: general anesthesia; hearing recovery; local anesthesia; otosclerosis; pure-tone audiometry; stapes surgery.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anesthesia, General*
  • Anesthesia, Local*
  • Bone Conduction
  • Evidence-Based Medicine
  • Hearing Loss, Sensorineural / etiology
  • Humans
  • Otosclerosis / surgery*
  • Postoperative Complications / etiology
  • Risk Factors
  • Stapes Surgery*
  • Vertigo / etiology