The Problem of the Sensorineural Component in Otosclerotic Hearing Loss: A Comparison between Operated and Non-operated Ears

Abstract

The behaviour of bone conduction audiograms in the operated and non-operated ears of 200 otosclerotic patients was analysed. The majority (84%) of both operated and unoperated ears showed virtually unchanged bone conduction thresholds throughout the follow-up period (mean follow-up period = 13.4 +/- 5.3 years). Slight but statistically significant bone conduction deterioration was observed in the remaining 16% of cases, most frequently in the non-operated ears. However, this deterioration was generally within the usually accepted limits of the Carhart effect, and does not demonstrate the presence of any causative factor other than evolution of the ostosclerotic disease. Our findings do not support the hypothesis that total stapedectomy per se may be responsible for sensorineural deterioration.

How Long Is Otosclerosis Surgery Effective? Hearing Results after a 22-Year Follow-Up

“…The present study describes hearing results obtained on average 22 years after surgical treatment for otosclerosis. This is, to our knowledge, the longest follow-up time; studies published to date refer to a mean observa- tional time of 12.5 years [Smyth et al, 1980;Faye-Lund et al, 1984;Birch et al, 1986;Del Bo et al, 1987;Langman et al, 1991;Vartiainen et al, 1993;Pirodda et al, 1995] Our most significant result concerns the stability of the BC threshold, which worsened by only 8 dB at long-term evaluation. This decay is much more considerable for 2 and 4 kHz: theoretically, a yearly decay of 0.5 and 0.6 dB, respectively, is expectable.…”

“…Vartiainen et al [1993] reports a better BC threshold in the operated versus unoperated ear after a 10-year follow-up: this advantage was attributed to the limitation of the otosclerotic focus due to the footplate removal. A subsequent study contrasted these results [Pirodda et al, 1995]: a non-significant BC decay was appreciated in the unoperated ear compared to the operated one after 13-year follow-up.…”

The Effect of Drinking Water Fluoridation on the Natural Course of Hearing in Patients with Otosclerosis

“…Ghonim (5) observed a mean deterioration of 7 to 12 dB in 80 non-operated otosclerotic ears during a mean followup of 1.8 years. On the other hand, Pirodda et al (6) found that bone conduction thresholds of non-operated ears deteriorated by only 3 to 7 dB in 200 patients with otosclerosis during a mean follow-up period of 13 years. The present study revealed the mean annual deterioration of bone conduction thresholds as being 0.6 to 1.7 dB/year; i.e., slightly …”

Hearing in Patients Operated Unilaterally for Otosclerosis. Self-assessment of Hearing and Audiometric Results

“…Another important consideration is that stapes surgery does not affect the otosclerotic process. The disease progresses over time, possibly resulting in impaired bone conduction (BC) and deterioration in cochlear function in both operated and non-operated ears (5). This deterioration may explain why after stapes surgery, patients often state that although their hearing ability has improved considerably, the quality of sound is different.…”