Predictive factors in 995 stapes surgeries for primary otosclerosis

Khorsandi, T A Mohammad; Jalali, Mir Mohammad; Shoshi, D Vahideh

doi:10.1002/lary.27160

Cited by 20 publications

(25 citation statements)

References 26 publications

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“…First, the logistic regression analysis showed that a smaller ABG at 250 Hz, 500 Hz, and 4 kHz was associated with better postoperative results, which is concordant with the results published by Kishimoto et al [2015], who found preoperative ABG at the same frequencies to be prognostic factors for better postoperative outcomes. A smaller ABG as a positive prognostic factor shown in this study is congruent with other studies [Ueda et al, 1999;Kishimoto et al, 2015;Khorsandi et al, 2018]. Indeed, Khorsandi et al [2018] recently reviewed 995 stapes surgeries and found that a smaller preoperative ABG was associated with a higher chance of better postoperative ABG closure (OR = 0.90; p < 0.001).…”

Section: Factors Associated With Better Outcomessupporting

confidence: 92%

“…A smaller ABG as a positive prognostic factor shown in this study is congruent with other studies [Ueda et al, 1999;Kishimoto et al, 2015;Khorsandi et al, 2018]. Indeed, Khorsandi et al [2018] recently reviewed 995 stapes surgeries and found that a smaller preoperative ABG was associated with a higher chance of better postoperative ABG closure (OR = 0.90; p < 0.001). We agree with the authors of this study who hypothesized that patients with larger ABG may have multiple otosclerosis lesions, or a more severe otosclerotic process.…”

Section: Factors Associated With Better Outcomessupporting

confidence: 92%

“…In the literature, the success rate <10 dB varies between 62 and 94% [Ueda et al, 1999;Vincent et al, 2006;Bittermann et al, 2011;Alberti et al, 2017;Khorsandi et al, 2018;Amrhein et al, 2019]. These differences may be explained by the type of surgery, the use of laser-assisted procedures, selection bias, and the surgeon's experience [Khorsandi et al, 2018].…”

Section: Postoperative Resultsmentioning

confidence: 99%

“…Indeed, Karkas et al [2009] specifically inves- tigated if the mean postoperative BC and ABG were different in 894 cases of stapedotomy and found no audiological differences. Conversely, Khorsandi et al [2018] did find the involvement of the right ear to be associated with excellent outcomes (OR = 2.00). However, as the authors clearly state, these findings should be interpreted with caution, as they might be due to chance, since two-thirds of obliterative footplates occurred in the left ears, which could explain the differences in outcomes between ears.…”

Section: Factors Associated With Better Outcomesmentioning

confidence: 89%

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Fifteen-Year Follow-Up of Stapedotomy Patients: Audiological Outcomes and Associated Factors in a Middle Income Country

et al. 2020

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Objective: To evaluate the short-term (postoperative), medium-term (5 years), and long-term (10 and 15 years) audiometric results of patients who underwent stapedotomy and to determine specific factors associated with better postoperative outcomes. Methods: This study is a retrospective case review of 486 ears with surgically confirmed stapes fixation who underwent microscopic small fenestra stapedotomy. Preoperative, postoperative, and medium- and long-term air conduction (AC), bone conduction (BC), and air-bone gap (ABG) were assessed. Postoperative factors associated with better postoperative outcomes were evaluated. Results: At 10- and 15-year follow-ups, ABG, AC, and BC were significantly deteriorated but clinically preserved in comparison with postoperative results. According to a multiple quantile regression, younger age was associated with better postoperative results at 0.25 kHz (p = 0.003) and 4 kHz (p = 0.028) and a smaller preoperative ABG was associated with better audiometric results at 0.25 kHz (p = 0.048), 0.5 kHz (p = 0.001), and 4 kHz (p = 0.001). In addition, younger age (p = 0.001 for AC and p < 0.001 for BC) and preoperative AC PTA (p < 0.001 for AC) were significantly associated with better postoperative AC and BC PTA. Conclusions: Stapedotomy surgery provides short-, medium-, and long-term hearing benefits in our studied cohort. ABG, AC, and BC thresholds obtained after the surgery are clinically preserved in 5-, 10-, and 15-year follow-ups, with an age-expected BC deterioration. Smaller preoperative ABG and younger age were positive predictors for better postoperative ABG. Future research should address long-term subjective and quality of life outcomes.

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Section: Factors Associated With Better Outcomessupporting

confidence: 92%

Section: Factors Associated With Better Outcomessupporting

confidence: 92%

Section: Postoperative Resultsmentioning

confidence: 99%

Section: Factors Associated With Better Outcomesmentioning

confidence: 89%

See 2 more Smart Citations

Fifteen-Year Follow-Up of Stapedotomy Patients: Audiological Outcomes and Associated Factors in a Middle Income Country

et al. 2020

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“…In another study that was published by Mohammad Khorsandi et al in 2018, the medical records of 995 patients with otosclerosis undergoing stapedectomy or stapedotomy was retrospectively investigated. The success rate of surgery in this study was reported 93.4% and it was said that the diameter of the prosthesis had no effect on the success rate, but the female gender and right ear involvement are reported as a prognostic factor in the good surgical outcome [14]. In this study, the size and diameter of the prosthesis were not related to auditory outcome and postoperative complications.…”

Section: Discussionmentioning

confidence: 51%

Determining the Incidence of Complications and Their Causes after Stapedotomy in Patients with Otosclerosis

Mohseni

Daneshi

Asghari

et al. 2019

JPRI

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Introduction: In order to treat the symptoms of otosclerosis, various surgical and medical treatments are suggested. Surgical treatments are the choice. This study aimed to determine the incidence of vertigo and its cause in Iran, and the present study focused on this issue. Methods: This was a prospective cohort study carried out on patients with otosclerosis undergoing stapedotomy referred to Rasoul Akram hospital, Tehran during 2017-18. The patients aged below 18 or those who had a history of vertigo were excluded. Diapasonic and audiometric tests were carried out. The follow-ups included the time of admission (the day after surgery) for the presence of vertigo using visual analogue scale and diapasonic tests, one week after surgery using visual analogue scale and diapasonic tests, and one month after surgery using visual analogue scale and audiometry. The data were imported to SPSS v.22 software and analyzed. Results: The surgical complications that occurred after stapedotomy for patients in this center were as follows: 12.1%of subjects had vertigo one day after surgery, 8.6% had vertigo one week later, and 1.7% had vertigo one month later, thus, the frequency of vertigo was reduced overtime. Meanwhile, 91.4% of the patients had a better sense of hearing and only 1.7% suffered from tympanic membrane perforation. In 8.6% of subjects, there was a disturbance in the taste. Tinnitus was only observed in 5.2% of the surgical patients in this center. Among women, vertigo was higher one day and one week after surgery. Logistic regression showed that age is significant predictor of dizziness one day after surgery (OR: 1.37, P=0.03). Conclusion: According to the results, the frequency of vertigo was decreased overtime. In this study, it was found that the complications of stapedotomy surgery were less than other surgical methods, but those who were older had significantly higher vertigo a week and one day after surgery indicating effective role of age on postoperative complications. Those who underwent surgery by tympanomeatal method had a better vertigo one day and one week after surgery.

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