Otosclerosis and stapedotomy: hearing improvement, complications, and analysis of potential prognostic factors in a series of 93 cases

TY - JOUR

T1 - Otosclerosis and stapedotomy: hearing improvement, complications, and analysis of potential prognostic factors in a series of 93 cases

AU - Wedel, Charlotte

AU - Holm, Niels Højvang

AU - Mirz, Frank

AU - Ovesen, Therese

N1 - https://doi.org/10.1080/00016489.2023.2231973

PY - 2023/7/20

Y1 - 2023/7/20

N2 - Background: Stapedotomy is a common treatment for conductive hearing loss in otosclerosis patients. Aims/objectives: Results of stapedotomy were assessed in terms of hearing improvement and risk of complications. Potential prognostic factors affecting outcomes were identified. Material and methods: Retrospectively, 93 stapedotomies were evaluated. The primary outcome was hearing improvement based on postoperative ABG ≤10 dB, Belfast rule of thumb, and AC gain ≥20 dB. Secondary outcomes were postoperative complications. Additionally, prognostic factors potentially affecting outcomes were analyzed (age, gender, comorbidity, preoperative audiometry, tinnitus, or vertigo). Results: A mean ABG of ≤10 dB was achieved in 59%. According to the Belfast rule of thumb, 75% achieved interaural symmetry within ≤15 dB and/or a mean AC 4 of ≤30 dB. A gain in AC 4 of ≥20 dB was achieved in 57% of primary surgeries. The larger the preoperative ABG, the better hearing after surgery. There was no significant difference in hearing improvement at early and late follow-ups. Transient vertigo was the most common complaint (37%). Taste disturbances were the most frequent permanent complication (14%). Conclusion and significance: Stapedotomy gave good audible improvement with a low risk of complications. Preoperative ABG was the only prognostic factor affecting the hearing outcome. Only one follow-up 6–12 months seems relevant.

AB - Background: Stapedotomy is a common treatment for conductive hearing loss in otosclerosis patients. Aims/objectives: Results of stapedotomy were assessed in terms of hearing improvement and risk of complications. Potential prognostic factors affecting outcomes were identified. Material and methods: Retrospectively, 93 stapedotomies were evaluated. The primary outcome was hearing improvement based on postoperative ABG ≤10 dB, Belfast rule of thumb, and AC gain ≥20 dB. Secondary outcomes were postoperative complications. Additionally, prognostic factors potentially affecting outcomes were analyzed (age, gender, comorbidity, preoperative audiometry, tinnitus, or vertigo). Results: A mean ABG of ≤10 dB was achieved in 59%. According to the Belfast rule of thumb, 75% achieved interaural symmetry within ≤15 dB and/or a mean AC 4 of ≤30 dB. A gain in AC 4 of ≥20 dB was achieved in 57% of primary surgeries. The larger the preoperative ABG, the better hearing after surgery. There was no significant difference in hearing improvement at early and late follow-ups. Transient vertigo was the most common complaint (37%). Taste disturbances were the most frequent permanent complication (14%). Conclusion and significance: Stapedotomy gave good audible improvement with a low risk of complications. Preoperative ABG was the only prognostic factor affecting the hearing outcome. Only one follow-up 6–12 months seems relevant.

KW - Otosclerosis

KW - air-bone gap

KW - hearing improvement

KW - postoperative complications

KW - prognostic factors

KW - stapedotomy

M3 - Journal article

SN - 0001-6489

VL - 143

SP - 563

EP - 569

JO - Acta Oto-Laryngologica

JF - Acta Oto-Laryngologica

IS - 7

ER -