Long-term hearing results after stapes surgery: a 20-year follow-up.

OBJECTIVE

The aim of this study was to evaluate the results of stapes surgery after 20 years of follow-up and to compare the results between large fenestra versus small fenestra stapedotomy.

STUDY

DESIGN

Retrospective clinical study.

SETTING

Tertiary referral center (university hospital).

PATIENTS: One hundred forty-two patients with otosclerosis treated by surgery.

INTERVENTION: Eighty patients had a total stapedectomy with House-wire prosthesis and 62 patients a stapedotomy with Teflon-piston prosthesis.

MAIN OUTCOME MEASURES: Preoperative, postoperative, and long-term hearing thresholds were compared. Patients filled in a questionnaire about the impact of surgery on the quality of life and postoperative symptoms.

RESULTS

The long-term pure tone average improvement did not differ significantly between the techniques compared with the preoperative values. The air-bone gap tended to enlarge as a function of time. The change in the pure tone average was 0.9 dB per year for both techniques. In the questionnaire, some patients reported vertigo, tinnitus, loud noise intolerance, and taste disturbances. Loud noise intolerance seemed to persist in the long term. Surgery had no effect on preoperative tinnitus.

CONCLUSIONS

There were no statistically significant differences between the techniques regarding hearing results. Over the long term, both techniques are safe and effective in restoring hearing and improving quality of life.