Stapes and Stapes Revision Surgery

What is it about?

Stapes surgery is considered an effective treatment in otosclerosis, but controversy remains regarding predictors of surgical outcome. Study Design: Retrospective cohort study. We reviewed one hundred sixty-three cases of stapes surgery between 2012 and 2019 at a tertiary referral center. Primary outcome measures were relative hearing improvement (relHI), defined as preoperative minus postoperative air conduction divided by a preoperative air-bone gap (ABG), as well as relative ABG closure (relABGc), defined as preoperative ABG minus postoperative ABG divided by preoperative ABG. Univariate and multivariate linear regression analyses were performed to determine independent predictors for these outcomes.

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Photo by Nick Grappone on Unsplash

Photo by Nick Grappone on Unsplash

Why is it important?

Higher preoperative bone conduction (BC) and primary surgery (compared with revision) were independently associated with increased relHI (p = 0.001 and p = 0.004, respectively). Lower preoperative BC, higher preoperative ABG, primary surgery, and age were independently associated with increased relABGc (p = 0.0030, p < 0.001, p = 0.0214, and p = 0.0099, respectively). Sex did not predict surgical outcome. In patients with less than 20 dB preoperative ABG, likelihood of negative relABGc was increased (compared with 20–30 dB or >30 dB preoperative ABG, p = 0.0292, Fisher's exact test). This tendency was not significant for relHI (p = 0.074).

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