The Rise and Fall of Otosclerosis: A Population-based Study of Disease Incidence Spanning 70 Years

Marinelli, John P.; Totten, Douglas J.; Chauhan, Kiran Kaur; Lohse, Christine M.; Grossardt, Brandon R.; Vrabec, Jeffrey T.; Carlson, Matthew L.

doi:10.1097/mao.0000000000002763

Cited by 18 publications

(32 citation statements)

References 32 publications

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“…For instance, in a recent incidence study of otosclerosis in the same population as the current study, the incidence rates of otosclerosis per 100,000 person-years in the first 3 years of the study (1970)(1971)(1972) were 24.6 in women and 13.6 in men. 15 By contrast, in the most recent 3 years (2015-2017), the incidence rates of otosclerosis were 3.2 in women and 3.1 in men. 15 These trends suggest that the differences in incidence rates between women and men have all but disappeared over the past 45 years.…”

Section: Discussionmentioning

confidence: 94%

Pregnancy, Estrogen Exposure, and the Development of Otosclerosis: A Case‐Control Study of 1196 Women

Macielak¹,

Marinelli²,

Totten

et al. 2020

Otolaryngol.--head neck surg.

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Objective This study sought to determine whether a history of pregnancy or bilateral oophorectomy is associated with subsequent otosclerosis development or disease severity. Study Design Population-based case-control study. Setting Olmsted County, Minnesota. Methods Women diagnosed with otosclerosis were matched to 3 women without otosclerosis based on age and historical depth of medical records. Associations of prior delivery and bilateral oophorectomy with subsequent development of otosclerosis and with pure-tone average (PTA) at the time of otosclerosis diagnosis were evaluated. Results We studied 1196 women: 299 cases of otosclerosis and 897 matched controls. The odds ratio for the association of ≥1 delivery with otosclerosis was 1.16 (95% confidence interval [CI] 0.85-1.60; P = .35). Odds ratios for the associations of 1, 2, 3, or ≥4 deliveries with otosclerosis were 1.22 (0.83-1.80), 1.09 (0.71-1.68), 1.28 (0.77-2.12), and 1.00 (0.54-1.84), respectively. The odds ratio for the association of prior bilateral oophorectomy with otosclerosis was 1.12 (0.58-2.18; P = .73). In cases with otosclerosis, PTA at diagnosis was not significantly higher for women with ≥1 delivery as compared with those without (median 45 dB hearing loss [HL] [interquartile range {IQR} 36-55] vs 43 [IQR 34-53]; P = 0.18) but was significantly higher for women with bilateral oophorectomy compared with those without (median 54 dB HL [IQR 44-61] vs 44 [IQR 34-53]; P = .03). Conclusion These data do not support a relationship between endogenous estrogen exposure and development of otosclerosis. Women with otosclerosis who had a history of pregnancy did not have significantly worse hearing at the time of diagnosis, suggesting that pregnancy is not associated with disease severity.

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Section: Discussionmentioning

confidence: 94%

Pregnancy, Estrogen Exposure, and the Development of Otosclerosis: A Case‐Control Study of 1196 Women

Macielak¹,

Marinelli²,

Totten

et al. 2020

Otolaryngol.--head neck surg.

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“…Otosclerosis symptoms appear between age 30 and 50 years. 1 , 2 , 6 , 21 Between 13% and 58% of cases are hereditary. 1 , 21 Otosclerosis surgery has a reported success rate of more than 90%.…”

Section: Methodsmentioning

confidence: 99%

Estimated Costs Associated With Management of Otosclerosis With Hearing Aids vs Surgery in Europe

et al. 2022

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IMPORTANCE Surgery and hearing aids have similar outcomes in terms of hearing acuity but differ in terms of cost, aesthetics, and patient quality of life. The cost-effectiveness and budget impact of otosclerosis treatments have never been studied in Europe.OBJECTIVES To compare the estimated mean costs per patient over 10 years of surgery vs hearing aids for the treatment of otosclerosis and to estimate the budget impact of an increase in the proportion of patients receiving surgical treatment. DESIGN, SETTING, AND PARTICIPANTS This economic evaluation analyzed French and Europeanepidemiological data on the surgical management of symptomatic otosclerosis and compared them with data from the literature to build economic models. The analysis was conducted in January 2021.EXPOSURES Two care pathways were considered in the treatment of otosclerosis, either hearing aid or surgery. MAIN OUTCOMES AND MEASURESCosts were studied over 10 years using Markov models of the 2 care pathways (hearing aid vs surgery). The budget impact analysis was performed over 5 and 10 years, assuming a 1-percentage point yearly increase in the proportion of patients receiving surgical treatment. RESULTSOver 10 years, the estimated mean cost per patient was significantly lower in the surgery group compared with the hearing aid group (€3446.

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confidence: 99%

“…To this end, a recent population-based study showed that the incidence of surgically confirmed otosclerosis declined from 12.9 cases per 100,000 person-years in the early 1970s to just 2.1 per 100,000 from 2015 to 2017. 3 Applying the age-and sex-standardized incidence rates of surgically confirmed otosclerosis to the 2010 US census data, residents' realistic case exposure to stapedectomy exposure throughout residency can be approximated. 3,4 Inclusion of reported survey data regarding the proportion of private practice otolaryngologists performing stapedectomy and surgeon comfort level with resident participation in this procedure also allows for more accurate estimation of individual resident experience with stapedectomies during training.…”

mentioning

confidence: 99%

“…3 Applying the age-and sex-standardized incidence rates of surgically confirmed otosclerosis to the 2010 US census data, residents' realistic case exposure to stapedectomy exposure throughout residency can be approximated. 3,4 Inclusion of reported survey data regarding the proportion of private practice otolaryngologists performing stapedectomy and surgeon comfort level with resident participation in this procedure also allows for more accurate estimation of individual resident experience with stapedectomies during training. 5,6 Last, any estimation of resident case exposure must include some consideration of the amount of cases they would observe before being a primary surgeon-for this purpose, we have assumed that residents observe the first 25% of cases seen.…”

mentioning

confidence: 99%

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With the Incidence of Otosclerosis Declining, Should Stapedectomy Remain a Key‐Indicator Case for Otolaryngology Residents?

Totten

Marinelli

Spear

et al. 2020

Otolaryngol.--head neck surg.

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Stapedectomy remains a joint key-indicator case with ossiculoplasty for otolaryngology residents in the United States. Yet, residents consistently report feeling inadequately prepared to perform stapes surgery following graduation. Applying recently described age- and sex-standardized incidence rates of surgically confirmed cases of otosclerosis to the US populace, upper and lower estimates of residents’ case exposure to stapedectomy can be approximated. With this, uppermost projections estimate 6484 new cases of stapes surgery are performed annually nationwide. With approximately 1424 otolaryngology residents nationally, the average case exposure is 7.8 stapedectomies throughout their training, with upper and lower estimates of 17.1 and 4.2 cases, respectively. As such, proficiency in stapedectomy is no longer a realistic expectation for US graduating residents. This reality supports the removal of “stapedectomy” from the list of 14 key-indicator case requirements, leaving ossiculoplasty as its own key-indicator case, thereby reinforcing true competence in this fundamental procedure for the graduating otolaryngologist.

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The Rise and Fall of Otosclerosis: A Population-based Study of Disease Incidence Spanning 70 Years

Cited by 18 publications

References 32 publications

Pregnancy, Estrogen Exposure, and the Development of Otosclerosis: A Case‐Control Study of 1196 Women

Pregnancy, Estrogen Exposure, and the Development of Otosclerosis: A Case‐Control Study of 1196 Women

Estimated Costs Associated With Management of Otosclerosis With Hearing Aids vs Surgery in Europe

With the Incidence of Otosclerosis Declining, Should Stapedectomy Remain a Key‐Indicator Case for Otolaryngology Residents?

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