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Audiological outcome of stapes surgery for far advanced cochlear otosclerosis

  • C Heining (a1), R Banga (a1), R Irving (a1), C Coulson (a1) and P Monksfield (a1)...
Abstract
Background:

Patients with advanced otosclerosis can present with hearing thresholds eligible for cochlear implantation. This study sought to address whether stapes surgery in this patient group provides a clinically significant audiological benefit.

Objectives:

To assess pre- and post-operative hearing outcomes of patients with advanced otosclerosis, and to determine what proportion of these patients required further surgery including cochlear implantation.

Methods:

Between 2002 and 2015, 252 patients underwent primary stapes surgery at our institution. Twenty-eight ears in 25 patients were deemed to have advanced otosclerosis, as defined by pure audiometry thresholds over 80 dB. The patients’ records were analysed to determine audiological improvement following stapes surgery, and assess whether any further surgery was required.

Results:

The audiological outcome for most patients who underwent primary stapes surgery was good. A minority of patients (7 per cent) required revision surgery. Patients who underwent cochlear implantation after stapes surgery (10 per cent) also demonstrated a good audiological outcome.

Conclusion:

Stapes surgery is a suitable treatment option for patients with advanced otosclerosis, and should be considered mandatory, before offering cochlear implantation, for those with a demonstrable conductive component to their hearing loss. A small group of patients get little benefit from surgery and subsequently a cochlear implant should be considered.

Copyright
Corresponding author
Address for correspondence: Dr Chris Heining, Ear, Nose and Throat Department, Gloucester Royal Hospital, GL1 3NN, UK E-mail: chrisheining@hotmail.co.uk
References
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1 Ruckenstein, MJ, Rafter, KO, Montes, M, Bigelow, DC. Management of far advanced otosclerosis in the era of cochlear implantation. Otol Neurotol 2001;22:471–4
2 Calmels, MN, Viana, C, Wanna, G, Marx, M, James, C, Deguine, O et al. Very far-advanced otosclerosis: stapedotomy or cochlear implantation. Acta Otolaryngol 2007;127:574–8
3 Rotteveel, LJ, Proops, DW, Ramsden, RT, Saeed, SR, van Olphen, AF, Mylanus, EA. Cochlear implantation in 53 patients with advanced otosclerosis:demographics, computed tomographic scanning, surgery, and complications. Otol Neurotol 2004;25:943–52
4 Merkus, P, van Loon, MC, Smit, CF, Smits, C, de Cock, AF, Hensen, EF. Decision making in advanced otosclerosis: an evidence-based strategy. Laryngoscope 2011;121:1935–41
5 Kabbara, B, Gauche, C, Calmels, MN, Lepage, B, Escude, B, Deguine, O et al. Decisive criteria between stapedotomy and cochlear implantation in patients with far advanced otosclerosis. Otol Neurotol 2014;36:73–8
6 Lachance, S, Bussières, R, Côté, M. Stapes surgery in profound hearing loss due to otosclerosis. Otol Neurotol 2012;33:721–3
7 van Loon, MC, Merkus, P, Smit, CF, Smits, C, Witte, BI, Hensen, EF. Stapedotomy in cochlear implant candidates with far advanced otosclerosis: a systematic review of the literature and meta-analysis. Otol Neurotol 2014;35:1707–14
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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