Otosclerosis and stapedotomy: hearing improvement, complications, and analysis of potential prognostic factors in a series of 93 cases.

Background: Stapedotomy is a common treatment for conductive hearing loss in otosclerosis patients.

Aims/objectives: Results of stapedotomy were assessed in terms of hearing improvement and risk of complications. Potential prognostic factors affecting outcomes were identified.

Material and methods: Retrospectively, 93 stapedotomies were evaluated. The primary outcome was hearing improvement based on postoperative ABG ≤10 dB, Belfast rule of thumb, and AC gain ≥20 dB. Secondary outcomes were postoperative complications. Additionally, prognostic factors potentially affecting outcomes were analyzed (age, gender, comorbidity, preoperative audiometry, tinnitus, or vertigo).

Results: A mean ABG of ≤10 dB was achieved in 59%. According to the Belfast rule of thumb, 75% achieved interaural symmetry within ≤15 dB and/or a mean AC₄ of ≤30 dB. A gain in AC₄ of ≥20 dB was achieved in 57% of primary surgeries. The larger the preoperative ABG, the better hearing after surgery. There was no significant difference in hearing improvement at early and late follow-ups. Transient vertigo was the most common complaint (37%). Taste disturbances were the most frequent permanent complication (14%).

Conclusion and significance: Stapedotomy gave good audible improvement with a low risk of complications. Preoperative ABG was the only prognostic factor affecting the hearing outcome. Only one follow-up 6-12 months seems relevant.