Is gelfoam sealing necessary in stapes surgery?

Background: Sealing the oval window around the piston after fenestration with Gelfoam is a common practice in stapes surgery for otosclerosis.

Objectives: To analyse the effect of using or not using Gelfoam as a sealing material.

Methods: A retrospective study was performed on 418 patients who underwent stapes surgery from 2013 until 2019. Data were collected from medical records in a tertiary centre. 215 cases in the Gelfoam group and 203 cases in the control group without sealing were included. The main comparisons were made between these two groups in terms of vestibular (primary outcome) and audiological outcomes and complications.

Results: The patients' mean age was 47 years with a mean follow up of 50 months and a female predominance (65.6%,  = .049). There was no significant difference in terms of postoperative vertigo (11.6% vs 8.4%) or audiological outcomes in between Gelfoam and control group respectively. The average postoperative air-bone gap in the Gelfoam group was 4.6 dB vs. 5.3 dB in the control group ( = .634).

Conclusion And Significance: No difference were identified in vestibular or audiological outcomes during stapes surgery when using or not using Gelfoam in the middle ear.