Delaying partial stapedectomy for otosclerosis: effects on long-term hearing outcomes following surgery

Abstract

The purpose of this study is to evaluate hearing outcomes following partial stapedectomy according to age at the time of surgery and evaluate functional hearing at ≥ 10 years' follow-up, and to assess the effect of delay in surgery on overall functional hearing outcomes. Data were collected from patients operated upon for otosclerosis by a single surgeon from 1990 to 1999. Pure-tone air (PTA), pure-tone bone (PTB), air-bone gap (ABG), air-conduction at 8 kHz (AC 8), bone-conduction at 4 kHz (BC4) and speech discrimination score (SDS) were compared between patients <45 and ≥ 45 years old, as well as correlated with overall age preoperatively, short term (4 months) and long term (>10 years), postoperatively. Forty-five patients were included with a mean follow-up of 12.6 years. Mean preoperative ABG and AC 8 values were significantly different between the two age groups (p = 0.002; p = 0.010, respectively). No values remained significantly different between the two age groups at the long-term follow-up. ABG values correlated with age preoperatively (p = 0.001), although no correlation was seen short- and long-term postoperatively (p = 0.980; p = 0.495, respectively). Mean PTA, PTB, and ABG values showed a significant improvement in both groups preoperatively to short-term postoperatively (p < 0.001). Although mean PTA values decreased significantly from short- to long-term follow-ups in both groups (p = 0.033; p = 0.020), the improvement from the preoperative state remained significant (p < 0.001). Regardless of age at the time of surgery, long-term hearing levels will evolve similarly in patients <45 and ≥ 45 years old. Furthermore, no difference will be seen in hearing measurements between the two age groups at ≥ 10 years postoperatively. Delaying a surgery would thus not affect overall long-term hearing outcomes.

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

“…In the same study, no differences were found in hearing levels between the 2 age groups at 10 or more years after the operation; they concluded that the age (and ABG) of the patients at the time of surgery did not influence the results, which is consistent with our data. In parallel with Maniakas et al [2015] no differences in hearing measurements were found between our 2 groups at any of the postoperative follow-ups. Thus, regardless of the gap size at the time of surgery, overall hearing deterioration evolved similarly in patients with preoperative ABGs of less than or equal to 20 dB and those with more than 20 dB.…”

“…Salmon et al [2015] reported preoperative differences in age (42 and 50 years, respectively) and gender between the small and large ABG groups. Interestingly, Maniakas et al [2015] compared the results of partial stapedectomy in patients under 45 and over 45 years of age and found that younger patients had significantly smaller preoperative ABGs. In the same study, no differences were found in hearing levels between the 2 age groups at 10 or more years after the operation; they concluded that the age (and ABG) of the patients at the time of surgery did not influence the results, which is consistent with our data.…”