Is Preoperative Computed Tomography Necessary or Useful for Primary Stapes Surgery?

BACKGROUND Stapedotomy or stapedectomy is commonly performed to treat conductive (CHL) or mixed hearing loss (MHL), most often due to otosclerosis. Use of pneumatic otoscopy, tuning fork tests, diagnostic audiometry, and acoustic reflex testing are widely accepted to be sufficient for preoperative assessment. High-resolution computed tomography (CT) may reveal hypodense foci or bone deposition within the oval window and otic capsule. CT may also reveal other causes of the hearing loss. Use of preoperative CT varies widely. Some surgeons routinely obtain preoperative CT, whereas others reserve this for atypical presentations or when considering revision surgery. Preoperative CT incurs added cost and radiation exposure. Though there are a number of potential roles of CT prior to stapedotomy, the relative indications are poorly defined in the literature.