Role of LASER Stapedotomy in clinical improvement in subjective tinnitus among patients with Otosclerosis- a retrospective analysis

Abstract

Objective: To determine the prevalence and severity of subjective tinnitus in patients undergoing LASER stapedotomy at the Department of Otorhinolaryngology, AIIMS Patna. To evaluate the efficacy of LASER stapedotomy in clinically significant improvement in tinnitus in these patients Materials and methods: A retrospective study was conducted on 40 patients who underwent LASER stapedotomy from February 2018 to December 2019 at the Department of Otorhinolaryngology, AIIMS Patna. Pre- and post-operative audiological and tinnitus assessment was done. Hospital records were analyzed and otosclerotic patients with subjective tinnitus were included in the study. Prevalence and severity of tinnitus and accompanying degree of hearing loss across both genders were noted. Improvement in tinnitus postoperatively was evaluated. Results were analyzed using IBM SPSS Statistics software Version 20. Mean values were calculated and paired t-tests were applied to assess the role of LASER stapedotomy on tinnitus improvement. Results: Out of a total of 40 stapedotomy patients, 29 (72.50%) had tinnitus at presentation. The mean age of these patients was 29.59±9.3 years. The mean gain in air conduction threshold (ACT) and air-bone gap (ABG) closure was 19.68 dB and 12.14 dB respectively. Unilateral tinnitus was seen in 55.17% and bilateral in 44.83% of patients. High-frequency hearing loss was found in 65.51% of patients. Postoperatively, 44.83% of patients experienced a complete resolution in tinnitus, while all of them had an improvement in tinnitus severity. This result was similar in both males and females. Conclusion: Tinnitus is a frequent complaint of patients suffering from otosclerosis, which often takes a backseat in the treatment goals of a surgeon. It varies in severity and duration and is associated with a progressive worsening of hearing thresholds. LASER stapedotomy is an effective treatment modality, which not only improves post-operative hearing but also alleviates tinnitus to a great extent. Study design: A retrospective observational study Keywords: Otosclerosis. Tinnitus, LASER stapedotomy, Air Bone Gap (ABG)