Far-advanced Otosclerosis: The Role of Stapes Surgery

Introduction: Far-advanced otosclerosis (FAOS) hearing loss rehabilitation is performed, mainly with cochlear implantation. The study evaluates the benefit of stapes surgery in far-advanced otosclerosis.

Methods: A retrospective chart review of all patients with FAOS (PTA>85dBHL) who underwent stapes surgery during 4 years period, was conducted. Pre- and post-operative hearing audiograms were analyzed and overall audiological improvements were reported. PTA as calculated in 4 frequencies (500Hz, 1000Hz, 2000Hz, 3000Hz).

Results: Of 168 patients who underwent stapes surgery, 14 patients (8%) were found eligible for FAOS. Ten patients (71.4%) were males with a mean age of 56 years (range 35-71). The mean follow-up period was 10 months (range 1-31 months).

Hearing results characteristics included: PTA improved from 100dBHL to 76dBHL in average (Δ 24dBHL, range; -1-58dBHL) with similar improvement in speech recognition threshold (Δ 28dBHL; range; 10-45dBHL). The mean speech discrimination score improved from 48% pre-operatively (measured in only in 1 patient) to 65% post-operatively (range; 42%-92%, measured in 12 patients).

Conclusions: Stapes surgery should be considered in patients with FAOS as an eligible option for hearing rehabilitation prior to cochlear implantation.