Primary and revision stapedectomy in elderly patients

This review discusses the recent literature on short- and long-term hearing results for primary and revision stapes surgery on young and elderly patients.

The epidemiology of clinical otosclerosis appears be changing. The average age for patients undergoing primary stapes surgery is increasing, and the percentage of revision stapedectomies is increasing. As the population ages, the otologist should expect to perform more surgeries on elderly patients. Short- and long-term hearing results after primary stapes surgery are good, regardless of age. Approximately 90% of patients obtain closure of their ABG to within 10 dB. Long-term results demonstrate that hearing decreases over time after stapedectomy at a rate of approximately 1 dB/y for both young and elderly populations. Sensorineural hearing loss accounts for most of this decrease and a relatively small ABG is maintained in many patients. However, at least 10 to 20% of patients will redevelop conductive hearing loss after undergoing stapes surgery and will desire revision surgery to correct this hearing loss. With modern otologic equipment, including the laser, most patients undergoing revision stapedectomy should obtain significant improvement in hearing, regardless of age.

Primary and revision stapedectomy are beneficial procedures in the elderly population. The success rate is similar to that in the younger population with otosclerosis.