Predictive Role of Audiological and Clinical Features for Functional Results after Stapedotomy

Abstract

Objective: To analyze and compare the preoperative factors that potentially influence the outcome of stapedotomy in our study group. Materials and Methods: 161 cases were enrolled. Clinical variables considered to influence functional results – air conduction (AC) and bone conduction (BC) pure-tone average (PTA), air-bone gaps (ABG), sensorineural hearing loss (SNHL), ABG gain and ΔSNHL – were gender, age, case type (unilateral vs. bilateral), ear side (right vs. left), pregnancy, vascular disease and family history of otosclerosis. The audiometric variables were preoperative AC- and BC-PTA, SNHL and ABG. Results: Univariate logistic regression analysis showed that the probability of obtaining a ≥10 dB gain is significantly affected by the following factors: age <50 years, AC-PTA ≥50 dB and preoperative ABG ≥30 dB. All the other factors included into the registration (gender, familiarity, side, bilateral vs. unilateral, pregnancy, vascular diseases and preoperative BC-PTA) were not found to significantly affect postoperative gain (p > 0.05). Nevertheless, multivariate logistic regression analysis maintained a statistically significant correlation only between gain ≥10 dB and both preoperative ABG ≥30 dB and age <50 years. Conclusions: The accurate knowledge of predictive factors is a valuable tool that permits the surgeon to plan surgery with a better case selection as well as assisting in counseling the patient with regard to the likelihood of success of the procedure.

In search of correlation between hand preference and laterality of hearing impairment in patients with otosclerosis

“…The majority of our study patients (218/239, 91.2 %) reported being right handed, a finding in agreement with the studies on hand preferences in different populations [18][19][20][21]28]. Our findings on female prevalence among the patients with otosclerosis, mean age at presentation for stapes surgery and gender differences in handedness were consistent with those in the literature [2,3,[8][9][10][11][28][29][30][31].…”

“…A relatively few articles have focused specifically on the outcome of stapes surgery in relation to the laterality of otosclerosis, and no functional difference was found between a stapedectomy performed in the RE or LE [10,22]. However, the relation between the laterality of hearing impairment in otosclerosis and the patient's handedness had not yet been investigated.…”

“…It was found in normal listeners that the right ear (RE) is superior in dichotic listening, monaural speech stimuli, syntax structure, phoneme discrimination, and consonant-vowel recognition [4][5][6][7], whereas,the left ear (LE) is supposed to be superior in nonverbal sound presentation, brief melody listening, and intonation discrimination [4][5][6]. Bilateral otosclerosis (BO) has been reported in 38.9-90 % patients [8][9][10][11][12][13]. The RE advantage in righthanded individuals and the LE advantage in left-handed ones were demonstrated in individuals with a normal hearing and in a population with hearing impairment [14][15][16][17].…”

Predictors of Listening Capabilities and Patient Satisfaction After Stapes Surgery in Otosclerosis

“…On the other hand, patients' views of successful stapes surgery are more complex than only improvement in audiometry and absence of complications or revision surgery. It also comprises other aspects, such as stereophony (10); the listening abilities in various environments (11,12); and the absence of sound distortion, tinnitus, and dizziness ( 13).…”

“…In counseling before stapes surgery, tone audiometric values are commonly used as the only predictive factors of postoperative success. Other known positive predictive factors are age younger than 50 years (13) and long duration of the hearing loss (14). The predictive value of other preoperative factors is unknown, such as personality characteristics or speech recognition in the complex listening situations of daily life.…”