Otosclerosis and stapedotomy: hearing improvement, complications, and analysis of potential prognostic factors in a series of 93 cases

Abstract

Background

Stapedotomy is a common treatment for conductive hearing loss in otosclerosis patients.

Aims/objectives

Results of stapedotomy were assessed in terms of hearing improvement and risk of complications. Potential prognostic factors affecting outcomes were identified.

Material and methods

Retrospectively, 93 stapedotomies were evaluated. The primary outcome was hearing improvement based on postoperative ABG ≤10 dB, Belfast rule of thumb, and AC gain ≥20 dB. Secondary outcomes were postoperative complications. Additionally, prognostic factors potentially affecting outcomes were analyzed (age, gender, comorbidity, preoperative audiometry, tinnitus, or vertigo).

Results

A mean ABG of ≤10 dB was achieved in 59%. According to the Belfast rule of thumb, 75% achieved interaural symmetry within ≤15 dB and/or a mean AC₄ of ≤30 dB. A gain in AC₄ of ≥20 dB was achieved in 57% of primary surgeries. The larger the preoperative ABG, the better hearing after surgery. There was no significant difference in hearing improvement at early and late follow-ups. Transient vertigo was the most common complaint (37%). Taste disturbances were the most frequent permanent complication (14%).

Conclusion and significance

Stapedotomy gave good audible improvement with a low risk of complications. Preoperative ABG was the only prognostic factor affecting the hearing outcome. Only one follow-up 6–12 months seems relevant.

背景：镫骨切开术是耳硬化症患者传导性听力损失的常见治疗方法。

目的：根据听力改善和并发症风险评估镫骨切开术的结果。 确定影响结果的潜在预后因素。

材料和方法：回顾性评估了 93 例镫骨切除术。 主要结果是听力改善, 基于术后 ABG ≤10dB、贝尔法斯特经验法则和 AC 增益 ≥20dB。次要结果是术后并发症。 此外, 分析了可能影响结果的预后因素（年龄、性别、合并症、术前听力检查、耳鸣或眩晕）。

结果：59% 的患者取得平均 ABG ≤10dB。 根据贝尔法斯特经验法则, 75% 的患者实现 ≤15dB 以内的耳间对称性和/或平均 AC4≤30dB。 57% 的初次手术实现AC4 的增益≥20dB 。 术前ABG越大, 术后听力越好。早期和晚期随访时的听力改善没有显著差异。 短暂的眩晕是最常见的主诉（37%）。 味觉障碍是最常见的永久性并发症（14%）。

结论和意义：镫骨切开术带来了良好的听觉改善, 且并发症风险较低。 术前 ABG 是影响听力结果的唯一预后因素。 仅一次6-12 个月的随访似乎是相关的。

Keywords:

• Otosclerosis
• stapedotomy
• air-bone gap
• hearing improvement
• prognostic factors
• postoperative complications

Disclosure statement

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

Data availability statement

Data supporting the results and analysis can be inquired from corresponding author.