Review of a single surgeon’s stapedotomy cases performed with a nickel titanium prosthesis over a 14-year period

Abstract

Conclusion: Stapes surgery with a nickel titanium prosthesis is a safe and well-tolerated procedure that leads to a significant improvement in hearing outcomes.

Objective: To identify the efficacy and safety of stapedotomy procedures performed with a nickel titanium prosthesis for patients with otosclerosis.

Methods: A review of 431 unique stapedotomies performed over 14 years by a single surgeon at an academic tertiary care center yielded 312 cases with nickel titanium prosthesis that met inclusion criteria of otosclerosis diagnosis, initial surgery in operative ear, and presence of pre-operative and post-operative audiograms. Pure-tone averages (PTA) at baseline and 8 weeks after surgery were calculated over four frequencies; 0.5, 1, 2, and 4 kHz. Average air–bone gaps (ABG) were calculated from pre-operative and post-operative audiograms.

Results: Average pre-operative baseline PTA was 56.7 dB in the affected ear. Post-operative PTA was 30.1 dB, a 26.6 dB improvement. Initial average ABG was 29.7 dB, while post-operative ABG averaged 5.4 dB, a 24.2 dB improvement. Surgical success (closure of ABG within 10 dB) was achieved in 263 (84%) patients. Rate of surgical success was not correlated with age, gender, race, or affected ear. Complications included recurrent conductive hearing loss (14), progressive SNHL (4), and post-operative BPPV (3).

Chinese abstract

结论 使用镍钛假体的镫骨手术是一种安全、耐受的手术, 可以显着改善听力。

目的 确定用镍钛假体对耳硬化患者进行吻合切开术的有效性和安全性。

方法 对一个外科医生14年中在一个学术性三级护理中心进行的431次独立吻合切除术的回顾, 得出了312例带镍钛假体的病例符合接受标准, 这些标准包括耳硬化诊断、初次手术和术前后术的听力图。在四个频率上 (0.5、1、2和4 kHz) 计算出初始和术后8周的纯音平均值 (PTA) 。根据术前和术后听力图计算出平均气-骨隔距 (ABG) 。

结果 病耳中的平均术前基线PTA为56.7dB。术后PTA为30.1dB, 改善值为26.6dB。初始平均ABG为29.7dB, 而术后ABG平均为5.4dB, 改善值为24.2dB。在263例 (占84％) 患者中实现了手术成功 (ABG闭合在10dB之内) 。手术成功率与年龄、性别、种族或病耳并不相关。并发症包括复发性传导性听力损失 (14) 、进行性SNHL (4) 和术后BPPV (3) 。

Keywords:

• Otosclerosis
• stapedotomy
• hearing
• middle ear
• SNHL

Acknowledgments

IRB approval was obtained from our institutional review board, #74535.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.