Analysis of Long-Term Hearing Gains after Stapes Surgery with Piston Reconstruction for Otosclerosis

Abstract

We sought to assess the postoperative hearing gains at individual frequencies after stapes surgery with piston reconstruction for clinical otosclerosis. We analyzed the air conduction (AC) hearing gains at various audiometric frequencies in a sample of 1,168 stapes procedures with piston reconstruction performed on 911 strictly consecutive patients by one surgeon between 1963 and 1979. Assiduous follow-up of patients was attempted for at least 10 years. The audiometric results over time were stored for computer analysis. The mean AC gain over the speech frequencies (0.5, 1,2, and 3 kHz) was 35.5 dB at 1 year after operation, and the rate of deterioration over the next 19 years was 0.58 dB/y. The picture to emerge from the analysis is clear. The mean AC gain is maximal at nearly 40 dB for the audiometric frequencies of 0.25, 0.5, and 1 kHz. The mean AC gain at any given time after operation decreases with increasing frequency, at least for frequencies of > or = 1 kHz. For any frequency there is, with few exceptions, a significant decrease in the AC gain from one time period to the next.