Evaluation of Second-Ear Stapedotomy with the Glasgow Benefit Plot

Abstract

This study reports the evaluation of the results after 72 stapedotomies in patients with bilateral otosclerosis. All pre- and postoperative audiological data, together with all relevant information of the operations, were stored in a data base and analyzed retrospectively. The Glasgow benefit plot (GBP) is a useful method to evaluate the hearing results of each individual ear after stapes surgery in a more functional way rather than from a technical standpoint. Therefore, it has been used to assess the benefit obtained after second-ear stapedotomy. From the results it appears that a second operation on the contralateral side increases the chances of achieving at least one ‘normal’-hearing ear, and it makes symmetrical ‘normal’ hearing possible in the majority of the cases.

Otosclerose: resultados de estapedotomias

“…Embora a otosclerose seja uma doença com acometimento bilateral na maioria dos casos, há grande receio em se realizar a cirurgia bilateralmente devido aos riscos de perda auditiva neurossensorial. Como esse risco é menor com a estapedotomia (ao invés da estapedectomia), autores vem preconizando os benefícios da cirurgia bilateral principalmente quanto à localização da direção do som e melhora significativa da audição biauricular 7,8 . Parece haver um consenso em que a técnica que proporciona melhores resultados é a que o cirurgião domina com maior facilidade.…”

Indication for Surgery in Otosclerotic Patients With Unilateral Hearing Loss

“…The categorization into different preoperative groups is assumed to facilitate the prediction of the possible outcomes. De Bruijn et al (9) examine the results after 72 stapedotomies in patients with bilateral otosclerosis. Glasgow Benefit Plot has been used to assess the benefit obtained after secondear stapedotomy.…”

The Quartile Benefit Plot: A Middle Ear Surgery Benefit Assessment Scheme

“…The GBP can also be used to estimate the potential benefit of a second ear stapes surgery after first ear operation. In addition, several authors have used the GBP in the assessment of benefit after bilateral stapes surgery 7,8,9 . Nevertheless, any evaluation of post stapes surgery hearing outcome would not truly represent the patient's benefit if it did not account for additional assessment criteria such as postoperative SNHL.…”

“…The performance of bilateral stapes surgery has for long been a controversial issue. Several studies have been published to argue for or against the practice of bilateral stapes surgery 7,8,11,12 . Although it is reasonable to offer bilateral stapes surgery to patients with significant bilateral otosclerotic conductive hearing loss, this practice exposes the patient twice to the risk of adverse postoperative SNHL.…”

“…Socially acceptable hearing, defined as air‐conduction threshold <30 dB, and symmetrical hearing, defined as interaural difference in air conduction of <10 dB, is represented by the shaded region in area one. The GBP was also used by several authors to assess success following bilateral stapes surgery 7,8,9 . The non‐operated ear in the plot was simply replaced by the second operated ear (Fig.…”