Investigate the impact of surgical method on hearing outcomes and complication rates after otosclerosis surgery.

Records of patients more than 18 years old who underwent otosclerosis surgery were reviewed to identify prosthesis type, surgical approach, post-operative dizziness, overnight admissions and hearing outcomes.

A total of 132 stapedotomies were performed with McGee pistons and 144 stapedectomies were performed using ribbon loops. No sensorineural hearing loss was noted with both techniques. Stapedotomy patients had a statistically larger improvement in speech reception thresholds, but there was no significant difference in air–bone gap closure between the two methods. 3.7 per cent of stapedotomy patients experienced post-operative dizziness, which was not significantly different the 7.6 per cent dizzy after stapedectomy (p = 0.2037). Diazepam was prescribed for dizziness in 90.9 per cent (10/11) of dizzy patients with ribbon loops and 0 per cent of those (0/5) with McGee pistons (p = 0.0018).

Both approaches yielded similarly good air–bone gap closure and were found to be safe and effective with low post-operative dizziness.