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Stapes Surgery in Far-Advanced Otosclerosis
Moscillo Luca1,2, Eva Aurora Massimilla1, Mastella Americo2
1ENT Department, L. Vanvitelli University, Naples, Italy.
Ear, Nose, & Throat Journal
|May 11, 2021
Summary
Stapes surgery for far-advanced otosclerosis (FAO) significantly improves hearing and speech perception in most patients. Cochlear implants (CI) should be considered only if stapes surgery fails.
Area of Science:
- Otolaryngology
- Neurosurgery
- Audiology
Background:
- Surgical treatment for far-advanced otosclerosis (FAO) lacks standardization.
- Patients with FAO are candidates for either stapes surgery or cochlear implantation (CI).
- While stapes surgery is often preferred, CI offers excellent hearing outcomes.
Purpose of the Study:
- To evaluate the efficacy of stapedotomy in patients with far-advanced otosclerosis (FAO).
- To compare stapedotomy outcomes with potential cochlear implant (CI) candidacy.
- To assess long-term hearing results after stapedotomy in FAO patients.
Main Methods:
- Retrospective analysis of 11 adult patients with FAO who underwent stapedotomy between 2006 and 2016.
- Pre- and post-operative pure-tone average (PTA) measurements (0.5-1-2-3 kHz) were recorded.
- Speech perception tests with hearing aids were conducted before and after surgery.
Main Results:
- A statistically significant improvement in air conduction threshold (PTA) was observed.
- Satisfactory speech recognition results were achieved in 81.8% of cases.
- Outcomes were not influenced by prosthesis type and remained stable over a 3-year follow-up.
Conclusions:
- Stapes surgery is recommended as the primary treatment for patients with far-advanced otosclerosis (FAO).
- Cochlear implantation (CI) should be reserved for cases where stapes surgery is unsuccessful.
- This approach prioritizes preserving natural hearing pathways when feasible.
