Functional outcomes of otosclerosis surgery

TL;DR

This study evaluates the success of otosclerosis surgery, finding better outcomes with early disease stages and specific surgical techniques.

Contribution

The study identifies predictors of hearing success and tinnitus regression in otosclerosis surgery.

Findings

Hearing success was achieved in 89.5% of patients with a postoperative air bone gap ≤10 dB.

Early Aubry and Portmann stages were independent predictors of better surgical outcomes.

Tinnitus regression occurred in 79.2% of cases, influenced by male sex and early radiological stages.

Abstract

•Better results with early Aubry stages (I and II).•Better functional outcomes with early Portmann stages.•Stapedectomy exposes to a higher risk of air bone gap reopening in long-term.•Better auditory results and less complications with calibrated platinotomy.

Better results with early Aubry stages (I and II).

Better functional outcomes with early Portmann stages.

Stapedectomy exposes to a higher risk of air bone gap reopening in long-term.

Better auditory results and less complications with calibrated platinotomy.

The objectives of this work were to evaluate the results of otosclerosis surgery and to study the predictors of its functional success.

Our study was retrospective on 322 patients, equivalent to 418 ears operated in the otolaryngology and head and neck surgery department, from January 2000 to December 2020.

Hearing success was noted in 89.5% of patients considering the Postoperative Residual Air Bone Gap (PRABG) ≤10 dB criterion; in 94.3% of patients according to the conductive gain ≥20 dB criterion; in 96.4% of patients based on the improvement of cochlear reserve criterion; in 88.8% according to the Air Bone Gap improvement (ABGi) ≥70% criterion and in 81.8% considering all these criteria. The short, medium and long-term postoperative tonal audiometries could be superimposed, reflecting the stability of the hearing results. A regression of tinnitus has been reported in 79.2% of cases. The independent predictors of hearing success were the Aubry's audiometric stages I and II, mean preoperative air curve >40 dB and platinotomy. The independent predictors of tinnitus regression retained were male sex, no exposure to loud noise and Veillon radiological stages I and II.

The identification of factors influencing the functional results of surgery allows a better selection of candidates for the intervention and more relevant information for patients.

Level 3: Non-randomized controlled cohort or follow-up study.

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