Related Experiment Video
Updated: Jan 11, 2026
Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach
Published on: March 5, 2022
Assessing Risk of Stapedectomy in Patients With Otosclerosis and Semicircular Canal Dehiscence
Neil M Sperling1, Matthew D Adams2, Boris Kumaev3
1Department of Otolaryngology-Head and Neck Surgery Surgery, Lenox Hill Hospital, Northwell Health, New York.
Objective:
To investigate the effect of semicircular canal dehiscence (SCD) on surgical outcomes in patients with otosclerosis.
Study Design:
Case series with chart review.
Setting:
Tertiary referral center.
Patients:
Eighteen patients were identified with concomitant, clinically suspected otosclerosis and radiographic SCD. Eight patients underwent primary stapes surgery, 2 underwent revision stapes surgery, 6 were advised against surgery, and 2 patients were evaluated after unsuccessful stapes surgery done elsewhere and had worsened hearing or unmasked third-window symptoms. Some patients were not offered stapes surgery due to presumed higher risk.Intervention(s):Review audiometric, and radiographic evaluations of patients who were diagnosed with both otosclerosis and SCD.Main outcome measure(s):Preoperative and postoperative audiometry, radiographically measured approximate dehiscence area (ADA), and symptoms in patients with otosclerosis and semicircular canal dehiscence were evaluated.
Results:
Six of 8 (75%) primary stapedotomy patients had closure of the air-bone gap (ABG) to <10 dB, while 1 patient had >20 dB ABG. Both revision stapedotomy patients had >20 dB ABG postoperatively. No patients operated by the authors reported unmasking of third-window symptoms after stapes surgery. ADA was not significantly different in patients in the unoperated versus primary/revision stapes surgery group. One patient who had a present cVEMP threshold did not close their ABG after stapes surgery, whereas 2 patients with absent cVEMP thresholds did.
Conclusions:
In select patients, stapes surgery can result in improved hearing when otosclerosis and SCD coexist. Measurements of dehiscence area were not shown to predict surgical outcomes. CT imaging combined with VEMP testing appear to be valuable tools to assess risk of stapes surgery.
