Far-Advanced Otosclerosis

Abstract

Patients with ‘far-advanced’ or ‘very far-advanced’ otosclerosis have a profound bilateral hearing loss, with apparently no cochlear reserve measured by standard clinical audiometers. These patients have no benefit from a powerful hearing aid, have severe feedback problems and the cochlear implant may be the only solution. A total of 12 stapedotomies were performed in 8 patients with far-advanced or very far-advanced otosclerosis, with satisfactory results, improved air conduction thresholds and improved cochlear function and speech discrimination. Stapedotomy is a useful procedure for patients with far-advanced otosclerosis which improves patient’s hearing to levels where they can benefit from less powerful hearing aids with fewer feedback problems, compared to no measurable preoperative hearing aid benefit. It also spares those patients being submitted to cochlear implantation.

Otosclerose: resultados de estapedotomias

“…A estapedotomia, comparada com a estapedectomia, é menos traumática para a cóclea, promovendo uma audição melhor a longo prazo (principalmente em freqüências elevadas), além de ser de mais fácil execução devido ao menor sangramento, melhor visão da janela oval, menor tempo cirúrgico e mínimo desconforto pós-operatório; também oferece menos risco de deslocamento da prótese 2,3,5 . Em pacientes com otosclerose avançada, a estapedotomia também é um procedimento muito útil, uma vez que melhorando os níveis de audição, os pacientes podem se beneficiar do uso de próteses auditivas de menor potência 6 . 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.…”

Stapedotomy in Cochlear Implant Candidates With Far Advanced Otosclerosis

“…Some studies also included patients with conventional otosclerosis and, thus, also ears with a speech recognition score higher than 50% were presented. We excluded these ears (n = 23) from further analysis (6,11,19). In summary, the literature search identified 92 ears with FAO in which a stapedotomy was performed.…”

“…Alternatively, patients may be treated with stapedotomy and fitted with hearing aids. Stapedotomy is a relatively simple and cost-effective procedure that can result in a good outcome in patients with FAO (11,12). Nonetheless, the performance after stapedotomy can be disappointing because it is hard to predict the outcome of stapedotomy in patients with mixed hearing loss (13Y15).…”

Reply

“…Dear Sir, Many thanks to Iurato et al for their valuable comments about our article [1]. Here is our reply.…”