Hearing in Patients Operated Unilaterally for Otosclerosis. Self-assessment of Hearing and Audiometric Results

Abstract

The objective of this study was to examine the outcome of unilateral stapes surgery in one patient group with bilateral hearing loss and one group with unilateral hearing loss. The patients' own estimations of improvement in hearing ability and the occurrence of other ear-related symptoms were examined retrospectively and in a follow-up study. Ninety-five of 123 patients operated for otosclerosis in only one ear between 1987 and 1992 responded to a follow-up examination. Observed audiometric findings and changes thereof, along with the patients' own estimations of their hearing handicap pre- and postoperatively, and the occurrence of other ear-related symptoms were studied. Despite good surgical results (closure of air-bone gap within 20 dB in 94%), 33% of the patients had severe hearing disabilities postoperatively, and many of these patients needed further amplification with a hearing aid. Mild dizziness occurred in 33% of the patients postoperatively and did not decrease over time. Discomfort in the operated ear due to strong sounds was reported in 20%. Change in sound quality occurred in 80% of the operated ears, but tended to disappear over time. From the results of this study it may be concluded that surgery in one ear only, leaving the other ear with poor hearing, is not an optimal hearing rehabilitation of patients with otosclerosis. It is important endevour to achieve bilateral hearing in order to give the patient good social hearing. Postoperative dizziness and unpleasant hearing quality do occur frequently, and the patients need to be informed about these problems preoperatively.

Estimated Costs Associated With Management of Otosclerosis With Hearing Aids vs Surgery in Europe

“…(2) use of a hearing aid after surgery because of decreased hearing or insufficient improvement. [8][9][10][11] The risks related to surgery are therefore greater than those related to hearing aids and also have financial consequences.…”

“…Regardless of the technique used, operations can safely be performed as outpatient procedures . The success rate is greater than 90%, and long term outcomes (>5 years) are good (residual air-bone gap lower than 10 dB) and associated with a very low (ie, <1%) risk of deafness . However, other complications need to be considered, such as (1) revision surgery because of decreased hearing, complications, or lack of improvement after the initial operation and (2) use of a hearing aid after surgery because of decreased hearing or insufficient improvement .…”

“…The success rate is greater than 90%, and long term outcomes (>5 years) are good (residual air-bone gap lower than 10 dB) and associated with a very low (ie, <1%) risk of deafness . However, other complications need to be considered, such as (1) revision surgery because of decreased hearing, complications, or lack of improvement after the initial operation and (2) use of a hearing aid after surgery because of decreased hearing or insufficient improvement . The risks related to surgery are therefore greater than those related to hearing aids and also have financial consequences.…”