Whether cochlea involvement on CT in otosclerosis patients impacts the effect of stapedotomy

Abstract

Background

The success rate of stapedotomy in otosclerosis patients with cochlea involvement was unknown.

Aims/objectives

To determine the difference of surgical outcomes and symptomatology in otosclerosis patients with or without cochlea involvement on CT.

Material and methods

79 otosclerosis patients were included and grouped by HRCT, including cochlear-involved otosclerosis (C-group) or non-cochlear-involved otosclerosis (NC-group, control group). Patients were defined as NC-group in the presence of normal or solely fenestral involvement, or C-group if the hypodensities involve other parts of the labyrinthine bone Patients in the control group were collected at a 2:1 ratio to the C-group with similar follow-up times. Detailed complaints and surgical outcomes were compared between these groups.

Results

Chief complaints were similar in the C-group and NC-group. Although postoperative AC, BC, and ABG decreased significantly in both groups, the success rate was significantly higher in C-group regarding the postoperative ABG ≤10 dB. Furthermore, diffuse lesions may indicate a more severe disease and a poorer prognosis.

Conclusions and significance

Stapedotomy was effective for clinical otosclerosis. The surgical outcome was inferior favorable for cochlea involvement patients, especially for cases with widely involvement. There was no difference in chief complaints among patients with different CT degree of otosclerosis.

Chinese abstract

背景：耳蜗受累耳硬化症患者的镫骨切除术的成功率未知。

目的：用CT确定有或没有耳蜗受累的耳硬化患者的手术结果和症状的差异。

材料和方法：79例耳硬化患者被纳入研究, 并根据HRCT分组, 包括耳蜗累及耳硬化（C组）或非耳蜗累及耳硬化（NC组, 对照组）。通常受累或仅窗孔受累的患者被归为 NC 组。如果低密度涉及迷路骨的其他部分的患者则归为C组。 对照组患者与 C 组患者的比例为 2:1 , 随访时间相似。比较了这两组之间的详细主诉和手术结果。

结果：C组和NC组的主诉相似。虽然术后两组的 AC、BC、ABG均显著降低, 在术后 ABG 10 dB 方面, C组成功率高得多。此外, 弥漫性病变可能标示更严重的病情, 更差的预后。

结论与意义：镫骨切除术治疗临床耳硬化症是有效的。耳蜗受累患者的手术结果较差, 尤其是受累范围大的病例。不同CT耳硬化症程度的患者之间, 主诉并无差异。

Keywords:

• Cochlear-involved otosclerosis
• stapedotomy
• high-resolution computerized tomography (HRCT)
• auditory

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by National Natural Science Foundation of China [No. 82071048] and Excellent doctor-Excellent Clinical Researcher Project of Eye and ENT Hospital, Fudan University [SYB202005].