[Surgical treatment of otosclerosis. Effects and risks]

Surgical treatment of otosclerosis involves an opening of the labyrinth and, accordingly, a risk of complications from that organ: vertigo and sensorineural hearing loss or anacusis. During the past decade, the number of new patients with otosclerosis has stabilized at a low level in Danish ENT-departments. Thus, typically the number of stapedectomies per year per department is between 10 and 25. The study elucidates effects and risks at the operation, focusing in particular on the question whether this treatment ought to be centralized. In a seven-year period, a total of 75 stapedectomies in 73 patients with otosclerosis were performed at the ENT-department, Glostrup Hospital, Copenhagen. No revision operations were included. Hearing gain was obtained in all patients except two and the conductive hearing loss was eliminated in 87% of the cases. One patient developed severe sensorineural hearing loss caused by granuloma around the prosthesis, a very rare complication of uncertain cause. Thus, the results were satisfactory but in this series all operations except two were performed by the same expert surgeon in a department with high activity in otosurgery for other diseases. If similar conditions are not available a certain degree of centralization should be considered. The long-term results and the question of bilateral stapedectomy are discussed.