Stapes surgery in patients with profound hearing loss secondary to otosclerosis

Objective To evaluate the benefit of stapes surgery in patients with otosclerosis and profound hearing loss, who would meet audiometric criteria for cochlear implantation. Study DesignRetrospective study and questionnaireSettingTertiary care hospitalPatients33 adult patients (35 ears). Mean age 63.6 (range 40 to 85). InterventionStapedotomy with prosthetic implantationMain outcome measuresPure tone hearing threshold averages (PTA) recorded at 0.5kHz, 1kHz, 2kHZ and 3kHz, before and after surgery. Thresholds at 2 and 4kHz were compared separately. Glasgow Benefit Inventory (GBI) was used in 20 patients to assess quality of life changes. Results80% of ears demonstrated improvement in air conduction thresholds. Mean threshold improvement post-surgery was 26.3dB. 4 patients experienced unchanged air conduction hearing thresholds, while 3 patients experienced worsened thresholds. Mean GBI score was +17. Hearing aid use decreased in 25% and stopped entirely in 25%. One patient went on to undergo cochlear implantation.ConclusionPatients with otosclerosis and profound hearing loss who meet audiometric criteria for cochlear implantation benefit from stapes surgery quantitively and qualitatively. In most circumstances, stapes surgery improves hearing thresholds to a level where hearing aids are beneficial, or unnecessary, to the patient. This avoids cochlear implantation with auditory rehabilitation and a change in quality and tonality of sound.