Audiometric Results after Stapedotomy Operations in Patients with Otosclerosis and Preoperative Small Air-Bone Gaps

Abstract

Objectives: The efficacy of stapedotomies performed on patients with small air-bone gaps (<25 dB) was compared with the efficacy of the operation in patients who had otosclerosis with high air-bone gaps (≥25 dB). Methods: This retrospective study evaluates the short-term postoperative air and bone conduction thresholds and air-bone gaps after 182 CO₂ laser stapedotomies. Results: A significantly smaller air-bone gap and lower air conduction thresholds after surgery were observed in the group of patients who underwent surgery with preoperative air-bone gaps of less than 25 dB. Bone conduction thresholds improve in the group with small air-bone gaps after surgery. Conclusions: The results after stapedotomies are good even if the preoperative air-bone gap is small and the overall risk of hearing deterioration due to stapes surgery remains low.

Long-Term Hearing Outcomes following Stapedotomy in Patients with Otosclerosis and Preoperative Small Air-Bone Gap

“…In our study, no differences between the small and large ABG groups were found with respect to postoperative SNHL and high-frequency hearing loss. Similar to the results reported by Salmon et al [2015], the procedure, when performed on patients with preoperative small ABGs, was safe, and no complications were found in our series. The possibility of potential troubling associated tinnitus should also be mentioned.…”

“…The possibility of potential troubling associated tinnitus should also be mentioned. Considering effectiveness, however, the same study found smaller ABGs, lower AC thresholds and a higher percentage of overclosure after laser stapedotomy in a group of 76 patients who underwent surgery with an ABG < 25 dB [Salmon et al, 2015]. With regard to these measures, no differences between groups were found in the present study.…”

“…The current literature on the impact of the preoperative ABG gap at the time of surgery is limited [Lippy et al, 1997;Salmon et al, 2015], and to the best of our knowledge, this is the first study reporting long-term hearing results after stapedotomy in patients with otosclerosis and small ABGs. Performing or delaying stapes surgery remains a controversial topic involving 3 issues: incidence of complications, effectiveness in improving hearing, and stability of long-term results in hearing improvement.…”

“…ABGs within the range of 10-25 dB are considered small ABGs [Wiet et al, 1986;Lippy et al, 1997;Salvinelli et al, 2003;Salmon et al, 2015]. It has been suggested that surgery performed in patients with otosclerosis and preoperative small ABGs could result in better postoperative hearing outcomes [Hüttenbrink, 2003;Marx et al, 2011] and improved quality of life [Subramaniam et al, 2006].…”

“…It has been suggested that surgery performed in patients with otosclerosis and preoperative small ABGs could result in better postoperative hearing outcomes [Hüttenbrink, 2003;Marx et al, 2011] and improved quality of life [Subramaniam et al, 2006]. Lippy et al [1997] and, more recently, Salmon et al [2015] reported encouraging early postoperative results, with a low risk of hearing deterioration after stapedotomies performed in patients with preoperative small ABGs. However, postoperative success following stapes procedures should not be based on short-term evaluations of hearing, and no data are available for longer follow-up periods.…”