Hearing Outcomes of primary stapedotomy for 85 otosclerotic ears: a tertiary referral center experience

Document Type : Original Article

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otorhinolaryngology, Faculty of medicine, Alexandria university, Alexandria, Egypt

Abstract

Introduction: Otosclerosis is one of the common causes of conductive hearing loss in adults. We describe the outcomes of our series 85 ears (79 patients) operated in a tertiary referral center.
Materials: Patients operated for stapedotomy in our center from May 2019 to May 2023, excluding revision, trauma, chronic ear, previous ear surgeries.
Methods: Microscopic stapedotomy was performed for all our patients. The prothesis used was 4.5x0.6 mm whole Teflon. Pure tone audiometry for air, bone and air bone gap for 0.5, 1, 2, 4 KHz were calculated pre and post operatively and statistically analyzed.
Results: Out of 115 patients operated only 85 had complete records. All parameters improved with statistical significance. Among these air bone gap from 34.4 dB to 11.2 dB. Acceptable closure (upto 20 dB) was obtained in 78 ears (91.8%). Failure to close was observed in 7 ears (8.2%) with neither total nor profound sensory hearing loss.
Conclusions: Endomeatal microscopic stapedotomy is a safe and effective procedure for the management of otosclerosis. A 4.5 mm Teflon prothesis is suitable for most patients. However, various difficult situations could be encountered as narrow external auditory canal which rarely changes the approach to endaural or post auricular, narrow footplate, dehiscent hanging facial nerve, thick footplate. With appropriate management, most of these situations would not affect the success of surgery and abortion is rarely needed. Failure of ABG closure has multiple etiologies including slipped prothesis, incus erosion, short prothesis, insufficient widening of a narrow FP, wide prothesis’ loop.

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