Long-term hearing outcomes and determinants on patient-perceived benefits after bone cement fixation in stapedotomy

Stapes surgery using Teflon prostheses is widely performed for otosclerosis; however, prosthesis dislocation has been reported in approximately 3.5% of cases within the first two postoperative years.

To evaluate the seven-year audiological and patient-reported outcomes of stapedotomy with bone cement fixation.

This retrospective cohort study with prospective follow-up included patients who underwent stapedotomy with bone cement fixation between 2012 and 2022. Air conduction and bone conduction thresholds were assessed at short-term (0-1 years), mid-term (1-4 years), and long-term (4- years) follow-up. Patient-reported outcomes were evaluated using a procedure-specific questionnaire and the Glasgow Benefit Inventory (GBI).

Postoperative ABG improved significantly (p < 0.001) and remained stable during long-term. Progressive elevation in bone conduction thresholds was observed in both operated and contralateral ears. The mean GBI score was 47.5 ± 34.2, with 89% of patients reporting moderate to substantial benefit. Perceived benefit and willingness to recommend surgery were negatively associated with hospitalization difficulties, hearing aid use, and lifestyle limitations, and positively associated with tinnitus improvement and higher GBI scores.

Bone cement fixation in stapedotomy provides durable long-term hearing outcomes without adverse effects. Patient-perceived benefit is primarily determined by stable ABG closure and limited progression of sensorineural hearing loss.