Long-term hearing results of stapedotomy: analysis of factors affecting outcome
To evaluate long-term hearing results of stapedotomy and analyze the influence of patient-, disease-, and procedure-related variables.
Retrospective case series.
Tertiary referral center.
230 ears (202 patients, 10–74 years) underwent stapedotomy for otosclerosis between January 2008 and August 2014. All cases had early postoperative follow-up (4 weeks post-surgery) and 181 cases had late postoperative follow-up (≥ 1 year, average 32.5 months).
Stapedotomy procedure for otosclerosis.
Main outcome measures
Hearing outcome using conventional audiometry. The primary outcome parameter was the postoperative air-bone gap pure-tone average. Postoperative air-bone gap ≤ 10 dB was defined as surgical success. Preoperative, early postoperative and late postoperative hearing results were compared. Influence of patient- and procedure-related variables on hearing outcome was evaluated by logistic regression analysis.
The postoperative air-bone gap was 10 dB or less in 77.0% of cases early post-surgery and in 70.7% of cases in long-term follow-up. Air-bone gap closure within 20 dB was obtained in 95.7 and 92.3%, respectively. Logistic regression analysis demonstrated that a larger preoperative air-bone gap (p = 0.041) and positive family history of otosclerosis (p = 0.044) were predictive for less surgical success early postoperatively, but not on the long term. Age, gender, primary versus revision surgery, presence of preoperative tinnitus and preoperative vertigo did not independently and significantly influence postoperative air-bone gap closure.
Our series confirms excellent hearing results achieved in stapedotomy surgery, also in long-term follow-up. On the long-term no patient-, disease-, or procedure-related variables were identified as predictors of surgical success.
KeywordsOtosclerosis Stapedotomy Long-term Retrospective
The authors would like to acknowledge Dr. Ellen Deschepper for statistical advice.
Compliance with ethical standards
Conflict of interest
Authors Ingeborg Dhooge, Stéphanie Desmedt, Thomas Maly, David Loose and Helen Van Hoecke have no conflict of interest.
Statement of human rights
The study has been approved by the Ethical Committee of Ghent University Hospital, Belgium (Approval Numbers: 2014- 0760/2014-0761 and 2015-0198/2015- 0199) and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. As is involved a retrospective study, formal consent is not required.
- 8.Goh CG, Tan WS, Yeo SB (2013) Hearing results of stapes surgery in Singapore and predictive factors affecting outcome. Ann Acad Med Singap 42(9):S158Google Scholar
- 11.Niedermeyer HP, Arnold W, Neubert WJ, Sedlmeier R (2000) Persistent measles virus infection as a possible cause of otosclerosis: state of the art. Ear Nose Throat J 79(8):552–4, 6, 8 passimGoogle Scholar
- 32.de Bruijn AJ, Tange RA, Dreschler WA (2001) Efficacy of evaluation of audiometric results after stapes surgery in otosclerosis. I. The effects of using different audiologic parameters and criteria on success rates. Otolaryngol Head Neck Surg 124(1):76–83Google Scholar
- 33.Wegner I, Verhagen JJ, Stegeman I, Vincent R, Grolman W (2016) A systematic review of the effect of piston diameter in stapes surgery for otosclerosis on hearing results. Laryngoscope 126(1):182–190Google Scholar
- 36.Moscillo L, Imperiali M, Carra P, Catapano F, Motta G (2006) Bone conduction variation poststapedotomy. Am J Otolaryngol Head Neck Med Surg 27(5):330–333Google Scholar
- 40.Kashio A, Ito K, Kakigi A, Karino S, Iwasaki S, Sakamoto T et al (2011) Carhart notch 2-kHz bone conduction threshold dip: a nondefinitive predictor of stapes fixation in conductive hearing loss with normal tympanic membrane. Arch Otolaryngol Head Neck Surg 137(3):236–240CrossRefPubMedGoogle Scholar