Hearing results in adults after stapedotomy

Abstract

Background: Although clinical otosclerosis is considered a rare disease, it is the common cause of hearing loss in patients with an intact tympanic membrane. Also, the hearing loss is amenable to other non‑surgical remedies. However, stapes surgery is currently the preferred treatment modality. This study aimed to assess the short‑term hearing results in adults after primary stapedotomy, and find, if any, the effects of some variables on post operative hearing. Materials and Methods: This was a retrospective review of the clinical records of all consecutive patients who had primary stapedotomy for otosclerosis at the K. K. Ramalingam Ear, Nose and Throat Hospital and Research institute, Chennai, India between October 2011 and December 2011. Results: A total of 31 adults were studied; 19 (61.3%) were males and 12 (38.7%) were females. Their ages were between 21 years and 69 years; the mean age was 43.67 years, standard deviation (SD) 11.859 (95% CI; 39.24-48.10). The mean duration of symptom was 5.96 years; SD 6.188 (95% CI; 3.65-8.27). The commonest presenting symptoms were hearing loss (96.5%) and tinnitus (48.4%). The overall mean pre‑operative pure tone average was 56.54 dB, SD 10.866 (95% CI; 52.55-60.52), while the overall mean post operative pure tone average was 33.75 dB, SD 15.577 (95% CI; 28.03-39.46). This difference was found to be statistically significant (Z = −4.454; P = 0.000). The overall mean pre‑operative air bone gap was 43.14 dB; SD 6.824 (95% CI; 40.64-45.64) and the overall mean post operative air bone gap was 19.17 dB; SD 12.368 (95% CI; 14.63-23.70). This difference was found to be statistically significant (Z = −4.701). Nineteen patients (61.3%) had post operative air bone closure within 15 dB. The patient’s age significantly correlated with the post operative pure tone average (r = 0.443; P = 0.023). There was no significant correlation between the duration of disease and the post operative pure tone average (r = −0.034; P = 0.870). Conclusions: Primary stapedotomy was effective in improving short term hearing outcome in adults with clinical otosclerosis. In addition, the post operative hearing outcomes were not affected by the duration of the disease; but by an increase in the patient’s age.

Keywords: Hearing loss, otosclerosis, pure tone audiometry, stapedotomy

Nigerian Medical Journal | Vol. 54 | Issue 4 | July-August | 2013