Surgical Findings and Results of Stapes Surgery for Stapedial Fixation in Adults

Abstract

Received January 24, 2015 Revised March 24, 2015 Accepted March 27, 2015 Address for correspondence Hong Ju Park, MD, PhD Department of Otolaryngology, Aasan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea Tel +82-2-3010-3710 Fax +82-2-489-2773 E-mail dzness@amc.seoul.kr Background and ObjectivesZZStapes surgery has been reported to improve hearing for stapedial fixation. This study aimed to review the surgical findings and hearing results of stapes surgeries for 20 ears with stapedial fixation. Subjects and MethodZZWe reviewed the medical records and video recordings of 20 consecutive stapes surgeries between 2011 and 2014. Patient age ranged from 20 to 64 years, representing 5 males and 12 females. Mean audiologic follow-up duration was 11 months. Hearing improvement at the final pure-tone audiometry was determined to be successful when air-bone gap (ABG) was reduced to 20 dB or less, and excellent when ABG was reduced to 10 dB or less. Surgery-related deterioration of bone-conduction (BC) was determined to be positive when the difference between final and preoperative BC was more than 15 dB, and over-closure positive when final air-conduction (AC) was better than preoperative BC. ResultsZZPre-operative threshold frequency for BC and AC were 39.8±15.8 and 66.4±15.3 dB HL, respectively, and ABG was 26.6±10.2 dB. After the stapes surgery, the thresholds for BC and AC were 36.8±16.3 and 42.0±16.2 dB HL, respectively, and ABG was 5.2±6.5 dB during the last follow-up. After surgery, BC threshold was significantly improved at 2 kHz, whereas AC threshold improved at all frequencies. Excellent hearing improvement was accomplished in 16 ears (80%) and successful improvement in all ears (100%). Over-closure was observed in 7 ears (35%). There were no patients with surgery-related sensorineural hearing loss. ConclusionZZStapes surgery is effective for improving hearing for stapedial fixation. Operator should be able to cope with various situations during or after the stapes surgery. Korean J Otorhinolaryngol-Head Neck Surg 2015;58(7):469-74