Otosclerosis and stapedotomy: hearing improvement, complications, and analysis of potential prognostic factors in a series of 93 cases

Abstract

Background Stapedotomy is a common treatment for conductive hearing loss in otosclerosis patients. Aims/objectives Results of stapedotomy were assessed in terms of hearing improvement and risk of complications. Potential prognostic factors affecting outcomes were identified. Material and methods Retrospectively, 93 stapedotomies were evaluated. The primary outcome was hearing improvement based on postoperative ABG ≤10 dB, Belfast rule of thumb, and AC gain ≥20 dB. Secondary outcomes were postoperative complications. Additionally, prognostic factors potentially affecting outcomes were analyzed (age, gender, comorbidity, preoperative audiometry, tinnitus, or vertigo). Results A mean ABG of ≤10 dB was achieved in 59%. According to the Belfast rule of thumb, 75% achieved interaural symmetry within ≤15 dB and/or a mean AC4 of ≤30 dB. A gain in AC4 of ≥20 dB was achieved in 57% of primary surgeries. The larger the preoperative ABG, the better hearing after surgery. There was no significant difference in hearing improvement at early and late follow-ups. Transient vertigo was the most common complaint (37%). Taste disturbances were the most frequent permanent complication (14%). Conclusion and significance Stapedotomy gave good audible improvement with a low risk of complications. Preoperative ABG was the only prognostic factor affecting the hearing outcome. Only one follow-up 6–12 months seems relevant.