[Surgical treatment of otosclerosis. Long-term results]

At Glostrup Hospital, Copenhagen, exceptionally few stapedectomies were performed during the period 1979-1985. The audiological results five to eleven years after the operation were investigated in 64 patients. About half of the patients were operated using large fenester technique, the other half using small fenester technique. All patients but two were operated by the same expert surgeon. The initial results showed good stability with an unchanged median hearing gain of 30 dB. Eighty-five percent of the patients had an SRT < or = 35 dB HL in contrast to 89% at the 1-year follow-up (and five percent preoperatively). Eighty-two percent had an air-bone gap < or = 20 dB in contrast to 93% at 1-year follow-up (and 10% preoperatively). None of the patients had spontaneously developed severe sensorineural hearing loss, which was, however present in two patients as a direct result of the operation. In one of the patients it was caused by granuloma formation around the prosthesis, in the other patient it developed after a revision procedure. Both patients were operated using large fenester technique, which in general gave less satisfactory primary hearing improvement and less stable thresholds than small fenester technique.

Even under conditions with few operations per year the overall long term results of stapedectomy are satisfactory when performed by few trained ear surgeons, and in particular if small fenester technique is used. The risk of sensorineural hearing loss is primarily related to the operation.