Improved Bone Conduction and Hearing Outcomes After Stapes Surgery for Otosclerosis

Area of Science:

• Otolaryngology
• Audiology
• Neurosurgery

Background:

• Otosclerosis is a condition causing conductive hearing loss (CHL) due to abnormal bone growth in the middle ear, affecting the stapes.
• Stapes surgery aims to restore hearing by addressing stapes fixation, a common cause of CHL in otosclerosis.

Purpose of the Study:

• To evaluate bone conduction (BC) threshold improvements after stapes surgery for otosclerosis.
• To compare outcomes across different surgical techniques (total stapedectomy, partial stapedectomy, stapedotomy).
• To analyze short- and long-term results to guide otosclerosis treatment strategies.

Main Methods:

• Retrospective review of 173 patients (188 ears) undergoing stapes surgery for otosclerosis between 2009 and 2024.
• Analysis of pre- and postoperative pure-tone audiometry, medical histories, and operative records.

Main Results:

• Mean air conduction (AC) thresholds improved by 20.3 dB, and BC thresholds by 2.0 dB, with a mean air-bone gap (ABG) of 18.3 dB post-surgery.
• Significant improvements in BC thresholds were noted at 0.5, 1, and 2 kHz (1.3, 3.7, and 4.9 dB respectively), indicating CHL correction.
• Postoperative AC thresholds showed significant improvement across 0.5-4 kHz (p < 0.001), while BC thresholds slightly increased at 4 kHz.

Conclusions:

• Stapes surgery effectively improves BC thresholds at key frequencies, resolving the cochlear non-linearity (CN) and correcting conductive hearing loss (CHL) in otosclerosis.
• Despite a minor BC threshold increase at 4 kHz, substantial AC threshold gains and ABG closure confirm the procedure's efficacy.
• Postoperative BC threshold dynamics are clinically relevant for assessing surgical success and guiding otosclerosis management.