Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
Auditory and Vestibular Recovery in Otosclerosis Surgery: Clinical Efficacy and Predictive Modeling of Intraoperative Corticosteroid Use.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Aliyeva Aynur, Muradova Antiga, Hashimli Ramil
Аннотация
OBJECTIVE: To evaluate the effect of intraoperative local corticosteroid application on hearing, tinnitus, and dizziness outcomes after stapes surgery for otosclerosis, and to assess predictive modeling for treatment response.
STUDY DESIGN: Retrospective multicenter cohort study.
SETTING: Three tertiary referral hospitals.
METHODS: Two hundred primary stapedotomy patients were analyzed: Group 1 (n = 100) received topical triamcinolone acetonide (40 mg/mL) applied to the oval window/footplate; Group 2 (n = 100) underwent standard surgery without steroids. Preoperative and 3-month postoperative evaluations included pure tone thresholds, air-bone gap (ABG), speech discrimination score (SDS), Tinnitus Handicap Inventory (THI), and Dizziness Handicap Inventory (DHI). Machine learning algorithms identified predictors of a favorable response.
RESULTS: The steroid group achieved significantly greater hearing gains at all frequencies, most pronounced at 8000 Hz (28.13 ± 6.7 vs 19.09 ± 5.4 dB; P < .001), higher SDS (+6.37% vs -1.52%; P = .006), and superior ABG closure (P = .004). THI and DHI scores improved significantly (P < .001). Machine learning models achieved an AUC of 0.92 for outcome prediction.
CONCLUSION: Intraoperative corticosteroids significantly enhance auditory and vestibular recovery in stapes surgery and, combined with predictive modeling, may support personalized patient care.
STUDY DESIGN: Retrospective multicenter cohort study.
SETTING: Three tertiary referral hospitals.
METHODS: Two hundred primary stapedotomy patients were analyzed: Group 1 (n = 100) received topical triamcinolone acetonide (40 mg/mL) applied to the oval window/footplate; Group 2 (n = 100) underwent standard surgery without steroids. Preoperative and 3-month postoperative evaluations included pure tone thresholds, air-bone gap (ABG), speech discrimination score (SDS), Tinnitus Handicap Inventory (THI), and Dizziness Handicap Inventory (DHI). Machine learning algorithms identified predictors of a favorable response.
RESULTS: The steroid group achieved significantly greater hearing gains at all frequencies, most pronounced at 8000 Hz (28.13 ± 6.7 vs 19.09 ± 5.4 dB; P < .001), higher SDS (+6.37% vs -1.52%; P = .006), and superior ABG closure (P = .004). THI and DHI scores improved significantly (P < .001). Machine learning models achieved an AUC of 0.92 for outcome prediction.
CONCLUSION: Intraoperative corticosteroids significantly enhance auditory and vestibular recovery in stapes surgery and, combined with predictive modeling, may support personalized patient care.