Surgery for Otosclerosis: Results on 508 Patients

Abstract

Objective: The objective of our paper is to evaluate the hearing results after surgical treatment of otosclerosis from a retrospective analysis of 649 procedures performed by the same surgeon (484 stapedotomies, 69 total stapedectomies, 26 partial stapedectomies, and 70 revisions). We also evaluated the hearing improvement in patients with far-advanced otosclerosis. Method: We conducted a retrospective study on 649 operations performed on 508 patients between 1998 and 2005. The approach was endoaural under local anesthetic. Audiological evaluation has been performed according to the Committee on Hearing and Equilibrium–AAO-HNS guidelines. Results: We found results better after stapedotomy than stapedectomy with a postoperative ABG within 10 dB in 89.67% after stapedotomy, in 85.51% after total stapedectomy, and in 84.62% after partial stapedectomy. Stapedotomy was most reliable in the variation of the BC for high tones; we had a worsening of BC in 17.56% after stapedotomy and in 21.74% after stepedectomy. After revision surgery the outcomes were worse than primary surgery, with an ABG within 10 dB in 85.36% after revision of stapedotomy and in 82.76% after revision of stapedectomy. In far advanced otosclerosis, we obtained a mean postoperative ABG within 10 dB in 86.32%. Conclusion: This study confirmed stapes surgery allows for a good restoration of hearing function in a high percentage of cases with slightly better results after stapedotomy. Time of surgery is fundamental for recovery of hearing function since the outcomes are better in patients without sensorineural hearing loss.