Stapes Surgery in Far-Advanced Otosclerosis

Abstract

Introduction: Surgical treatment of patients with far-advanced otosclerosis (FAO) has not yet been standardized. Patients with FAO are the candidates for stapes surgery or cochlear implant (CI). Although many surgeons consider stapes surgery as the first choice, other authors prefer CI because of the excellent hearing results. Objective: The authors discuss their experience in the treatment of patients with FAO, potentially candidates for CI, who underwent stapedotomy. Materials and Methods: Eleven adult patients with FAO underwent stapedotomy from 2006 to 2016. Pure-tone average (PTA) between 0.5-1-2-3 kHz and speech perception test with hearing aids were determined before and after stapedotomy. Results: The results show a statistically significant improvement in air condition threshold (PTA) and satisfactory results with regard to speech recognition in 9 (81.8%) cases. Postoperative results are not influenced by the type of stapedotomy prosthesis employed and do not change during follow-up (3 years). Conclusions: The authors suggest first performing stapes surgery in patients with FAO and reserving CI in case of failure.

Outcomes of Cochlear Implantation in Patients with Far-Advanced Otosclerosis Who Had Previously Undergone Stapes Surgery

“…Patients with FAO can be offered 3 treatment options: (1) hearing aids, (2) stapedotomy, and (3) cochlear implantation (CI). 10 - 12 However, the benefits from hearing aids may be unsatisfactory, and so other surgical alternatives need to be considered. Current indications for stapedotomy have been greatly expanded, 13 , 14 but surgical correction of the conductive component alone may be insufficient.…”