Evaluación del cambio en el umbral de la vía ósea en pacientes operados de estapedectomía

Objectives To assess whether bilateral otosclerosis renders pre-operative bone conduction more inaccurate by increasing the Carhart effect. Methods Retrospective review of a database of pre and post-operative audiograms of 745 ears with otosclerosis treated with stapedectomy from 2013 to 2020 in a tertiary centre. Main outcome measures Change in bone conduction after stapedectomy for otosclerosis in: unilateral otosclerosis (U1); bilateral otosclerosis undergoing first side surgery (B1); bilateral otosclerosis undergoing second side surgery (B2). The magnitude of change in bone conduction post-operatively within and between each group. Results The average difference in pre and post-operative bone conduction was significant within in all groups (T-stat > 2 and P-value <0.05) with the greatest change observed in the U1 group. Analysis of average change in bone conduction between groups did not reach statistical significance (P-value = 0.37). Analysis of change per frequency demonstrated the greatest change in bone conduction post-operatively at 2000 Hz in all groups. The magnitude of change at 2000 Hz was the greatest in the bilateral groups; however, it did not reach statistical significance when compared to the unilateral group (P-value = 0.36). Conclusions This is the first study in the literature to assess the accuracy of pre-operative bone conduction in bilateral versus unilateral otosclerosis. There is no evidence that pre-operative bone conduction in bilateral otosclerosis is more inaccurate than in unilateral disease. In order to assess accuracy of pre-operative bone conduction in otosclerosis a reliable method of assessing post-operative bone conduction is required, without assumption of its equivalence to cochlear reserve.

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Stapedotomy for fenestral otosclerosis

Minni

Sementilli

Cialente

et al. 2022

Hearing Balance and Communication

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Objectives Otosclerosis is a progressive disease of the otic capsule characterised by disordered bone remodelling with abnormal resorption and neoformation of the temporal bone. Fenestral (or stapedial) otosclerosis is the most frequent form, when the focus of demineralisation involves the stapes footplate and the oval window. Stapedotomy and stapedectomy are indisputably the two main stapes surgery techniques for otosclerosis. The aims of this article are to evaluate the outcome of stapedotomy in terms of long-term audiological results and possible onset of late audiovestibular complications. Methods This retrospective study included 63 patients who underwent primary stapedotomy for treatment of conductive hearing loss due to otosclerosis with more than 15 years postoperative follow-up. Results We compared the preoperative results with the long-term stapedotomy results and observed an improvement of the pure tone average (PTA) for air conduction (AC) of 10.6 ± 7.6 dB and an average air/bone gap (ABG) improvement of 22.6 ± 5.7 dB. A surgical revision was necessary in two cases (3%). Complications included tinnitus in 5 cases and a temporary hypogeusia in two patients (3%); in the immediate postoperative period, 6 patients (10.2%) complained of vertigo. Conclusions Our results provide further evidence of the validity of stapedotomy as the reference technique for the surgical treatment of fenestral otosclerosis.

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Evaluación del cambio en el umbral de la vía ósea en pacientes operados de estapedectomía

Cited by 6 publications

References 14 publications

The Clinical Picture of Otosclerosis and the Surgery Effect on Bone Conduction Thresholds on Audiograms

The Clinical Picture of Otosclerosis and the Surgery Effect on Bone Conduction Thresholds on Audiograms

Does bilateral otosclerosis make pre-operative bone conduction more inaccurate?

Stapedotomy for fenestral otosclerosis

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