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CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(04): s00451811642
DOI: 10.1055/s-0045-1811642
Original Article

Effect of Controlled Hypotension on the Outcomes of Stapes Surgery

Authors

  • António Andrade 

    1   Department of Otorhinolaryngology, Centro Hospitalar Universitário São João, Porto, Portugal
    2   Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

  • João Viana Pinto 

    1   Department of Otorhinolaryngology, Centro Hospitalar Universitário São João, Porto, Portugal
    2   Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
    3   Centre for Health Technology and Services Research, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

  • Pedro Marques 

    1   Department of Otorhinolaryngology, Centro Hospitalar Universitário São João, Porto, Portugal
    2   Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

  • Manuel Mendes Leal 

    1   Department of Otorhinolaryngology, Centro Hospitalar Universitário São João, Porto, Portugal
    2   Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Porto, Portugal

  • Carla Pinto Moura 

    1   Department of Otorhinolaryngology, Centro Hospitalar Universitário São João, Porto, Portugal
    4   Department of Genetics, Centro Hospitalar Universitário São João, Porto, Portugal
    5   Institute for Research and Innovation in Health, Universidade do Porto, Porto, Portugal

Funding The authors declare that they did not receive funding from agencies in the public, private or non-profit sectors to conduct the present study.
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Abstract

Introduction

Stapes surgery (SS) benefits from adequate anesthetic bleeding control due to its microscopic nature and greater difficulty in hemostasis. Adequate hypotension during intervention is considered critical to achieving this goal.

Objective

To evaluate the role of controlled hypotension (CH) on surgical outcomes in SS.

Methods

We conducted a retrospective observational study in a tertiary academic center with adults submitted to SS from January 2017 to October 2022. Hypotension was considered controlled if the mean intraoperative arterial pressure was between 50 and 65 mmHg throughout the procedure. Patients were divided into CH and non-CH groups. Demographic data, medical history, anesthetic and surgical reports, perioperative complications, and audiometry results were studied.

Results

A total of 99 SS procedures were included. Of those, 23 met the criteria for CH. The non-CH group presented a nonsignificant longer operative time (71.4 ± 21.3 versus 83 ± 27.4 minutes; p = 0.065). No statistical difference was observed in complication rates related to the procedure (39.1 vs. 48.7%; p = 0.421). In terms of audiometric data, both groups showed comparable pre- and postoperative pure tone average (PTA) results (preoperative: 55.4 ± 11.3 versus 53.1 ± 16.2dB; p = 0.525; postoperative: 31.6 ± 10.2 versus 33 ± 17dB; p = 0.722). The postoperative average air-bone gap (ABG) was 9.3 ± 8.3 versus 10.1 ± 9dB; p = 0.709, while closure of the ABG was 24 ± 13.1 versus 19.7 ± 17dB; p = 0.287.

Conclusion

Controlled hypotension in SS does not appear to impact the audiometric outcomes or complication rates, despite having a potential role in the surgery duration.

Keywords

otosclerosis - stapes surgery - controlled hypotension

Authors' Contributions

AA: conceptualization, study design, resources, data collection and/or processing, data analysis and/or interpretation, literature search, writing – original draft, and writing – review & editing; JVP: study design, resources, data collection and/or processing, data analysis and/or interpretation, literature search, writing – original draft, and writing – review & editing; PM: study design, resources, data analysis and/or interpretation, literature search, writing – original draft, and writing – review & editing; MML: conceptualization, supervision, literature search, writing – original draft, and writing – review & editing; CPM: supervision, resources, data analysis and/or interpretation, literature search, writing – original draft, and writing – review & editing.


Data Availability Statement

The data supporting the findings of the present study are available from the corresponding author upon reasonable request.




Publication History

Received: 17 August 2024

Accepted: 14 July 2025

Article published online:
09 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
António Andrade, João Viana Pinto, Pedro Marques, Manuel Mendes Leal, Carla Pinto Moura. Effect of Controlled Hypotension on the Outcomes of Stapes Surgery. Int Arch Otorhinolaryngol 2025; 29: s00451811642.
DOI: 10.1055/s-0045-1811642