Hearing Levels of Patients with Otosclerosis 10 Years after Stapedectomy

Abstract

Hearing levels of 174 patients (213 ears operated on) with otosclerosis undergoing stapedectomy were analyzed. All patients had followup of 10 years or more, the mean follow-up period being 13.4 years. Eighty-seven ears (41%) underwent posterior crus stapedectomy, and in the remaining 126 ears (59%) a prosthesis was inserted. Large fenestra technique was used in all cases. In the long run, both air conduction and bone conduction thresholds of ears operated on showed remarkable deterioration from the best values obtained 6 to 12 months postoperatively. Ten years after surgery both air conduction and bone conduction thresholds of ears operated on were significantly worse than those of normal controls. At 10 years, 70 percent of the ears operated on had hearing levels (at 0.5 to 2.0 kHz) of 30 dB or better and 88 percent had 40 dB or better. At the last follow-up examination, in 90% of the patients the better hearing ear had a hearing level of 40 dB or better. In 90% of patients with bilateral otosclerosis who had operations in only one ear, the ear operated on had better hearing function than the opposite ear that had not been operated on.

Piston diameter in stapes surgery. Does it have a bearing?

“…This is in accordance with that reported earlier. [4,5] The mean air-bone gaps at speech frequency that is 500, 1000, and 2000 Hz were calculated in both the groups in preoperative as well as in postoperative periods. It was observed that both the groups had marked improvement in their respective follow-up periods.…”

Surgical Findings and Long-Term Hearing Results in 3,050 Stapedotomies for Primary Otosclerosis

“…Aarnisalo et al (22) observed that although there was an average reduction of 0.9 dB per year in both AC and BC thresholds during 20 years after stapes surgery (either with stapedotomy or stapedectomy), the ABG only increased by 2 to 4 dB during this period. Vartiainen et al (24) noted that the mean BC thresholds of otosclerotic ears that were surgically treated deteriorated during 10 years of follow-up. The study of Spandow et al (3) did not support these findings of a deterioration of BC thresholds.…”

Stapedectomy in Patients With Small Air‐Bone Gaps

“…Reported success rates for experienced surgeons have been high(up to 97%), 1,2 while complications such as a dead ear (0.6% to 3%) 3‐5 have been low. Although hearing levels in otosclerotic ears can gradually worsen over time, they generally remain better for operated ears than for nonoperated ears 6 . The onset of a hearing loss due to otosclerosis usually begins with a conductive loss in the low frequencies and progresses to a larger flat conductive loss as the footplate becomes completely fixed.…”

“…Although hearing levels in otosclerotic ears can gradually worsen over time, they generally remain better for operated ears than for nonoperated ears. 6 The onset of a hearing loss due to otosclerosis usually begins with a conductive loss in the low frequencies and progresses to a larger flat conductive loss as the footplate becomes completely fured. Some otosclerotic patients retain a small conductive hearing loss for years while others progress rapidly to a larger loss.…”