Analysis of Causative Disorders and Hearing Improvement in 100 Consecutive Stapes Surgeries

Abstract

Background and Objectives Stapes surgery has been widely used to improve the conductive hearing loss caused by stapedial fixation. The purpose of this study is to evaluate the causes of stapedial fixation using audiological results of 100 stapes surgeries. Subjects and Method We reviewed the medical records of 100 consecutive stapes surgeries between June 2011 and December 2022. A total of 100 ears from 86 patients were included and the patient age ranged from 6 to 80 years. Hearing improvements of pure-tone thresholds were defined as successful when air-bone gap (ABG) was reduced to 20 dB or less, and as excellent when ABG was reduced to within 10 dB. Results The causative diseases of stapedial fixation were otosclerosis (n=74, 74%), ossicular anomaly (n=19, 19%) and chronic otitis media (n=7, 7%). Overall, the pre-operative bone-conduction thresholds/air-conduction thresholds (BC/AC) thresholds were 32±14/58±18 dB HL and ABG were 26±11 dB while the postoperative BC/AC thresholds were 29±15/36±18 dB HL and ABG were 7±8 dB. The postoperative ABG was excellent in 77% and successful in 93%. The postoperative ABG was excellent in 82.4% and successful in 97.3% of otosclerosis, excellent in 78.9% and successful in 89.5% of ossicular anomaly, and excellent in 14.3% and successful in 57.2% for chronic otitis media. ABG significantly improved less in revision cases than in primary otosclerosis cases (p=0.006). Conclusion Stapes surgery is an effective method to improve hearing for various types of stapedial fixation. There was a difference in the degree of hearing improvement according to causative disorders.