Hearing results after stapes surgery

Abstract

Objective: To analyze the factors influencing the postoperative air―bone gap after stapes surgery in patients with otosclerosis. Study design: Retrospective clinical study Material and Methods: In this study, we evaluated the data from 113 ears of 98 patients who had undergone stapes surgery between April 2007 and October 2016. The air conduction thresholds and bone conduction thresholds in the patients were determined at frequencies of 0.5, 1, 2, and 3 kHz, before surgery and 6 months after surgery. A postoperative air―bone gap of less than 10 dB was defined as success. We performed univariate analysis of factors that could potentially affect the success rate, as follows: sex, age, bilateral or unilateral surgery, procedure performed（stapedotomy or stapedectomy）, technique（CO2 laser or manual perforator）, piston（Teflon or Teflon―wire）, operator, preoperative hearing level（air）, preoperative air―bone gap, and operation time. Then, we performed multivariate logistic regression analysis. Results: The success rate at six months after the surgery according to the criterion mentioned above（postoperative air―bone gap≦10 dB）was 67%. Univariate analysis revealed statistically significant correlations between the postoperative air―bone gap and the gender of the patient, surgical procedure performed（stapedotomy or stapedectomy）, preoperative hearing level（air）, preoperative air―bone gap, and operation time. Multivariate analysis identified male gender（OR 2.74）, unilateral surgery（OR 2.81）, higher preoperative air conduction threshold（OR per 1dB increase＝1.05）, and longer operation time（OR per 1 minute increase＝1.02）as independent risk factors. However, the method of fenestration, devices used for fenestration, use of prostheses or the operator exerted no significant influence on the success rate.