Related Experiment Video
Updated: Aug 5, 2026
07:35
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Reconsidering surgical thresholds for stapedotomy: multicenter outcome analysis
Matteo Di Bari1,2, Martina Sebastiani3,4, Hugo Delille2
1Otorhinolaryngology, Head and Neck Department, Ospedale Nuovo di Legnano, ASST Ovest Milanese, Via Papa Giovanni Paolo II, Legnano, MI, 20025, Italy.
Summary
Performing stapedotomy surgery for otosclerosis at lower hearing thresholds does not negatively impact hearing outcomes or increase complications. This suggests a patient-centered approach to surgical timing may be more beneficial than strict audiometric criteria.
Area of Science:
- Otolaryngology
- Audiology
- Surgical Outcomes
Background:
- Stapedotomy offers excellent hearing results for otosclerosis.
- Current surgical indication criteria, especially audiometric thresholds, lack universal consensus.
- Variations in recommendations exist globally, impacting patient care.
Purpose of the Study:
- To investigate if performing stapedotomy at lower preoperative hearing thresholds affects postoperative audiological outcomes.
- To determine if earlier intervention compromises results or increases complications.
Main Methods:
- Retrospective multicenter cohort study of adult patients undergoing primary stapedotomy for otosclerosis.
- Audiometric data collected pre- and post-operatively per AAO-HNS guidelines.
- Patients stratified by preoperative air-bone gap (ABG) and pure-tone average (PTA) thresholds for analysis.
Main Results:
- 615 stapedotomies analyzed; median postoperative ABG was 5 dB, with significant hearing improvement (p < 0.0001).
- Patients operated at lower preoperative ABG thresholds achieved comparable postoperative ABG closure.
- No significant difference in complication rates across audiometric subgroups.
Conclusions:
- Stapedotomy yields excellent hearing outcomes irrespective of preoperative hearing levels.
- Earlier surgery in patients with smaller air-bone gaps does not compromise results or increase risks.
- Findings support individualized, patient-centered surgical timing over rigid audiometric indications.
