Postoperative Hearing Outcomes of Stapedio-Vestibular Surgery in Patients with Otosclerosis Aged 65 Years or Older: A 20-Year Experience
DOI:
https://doi.org/10.51987/Rev.Hosp.Ital.B.Aires.v46i3.1326Keywords:
stapedotomy, stapes surgery, functional hearing loss, hearing results, hearing lossAbstract
Introduction: otosclerosis is an osteodystrophy of the otic capsule that affects the middle and inner ear, with an approximate prevalence of 1% in the general population, a female predominance, and usual onset between 30 and 40 years of age. It primarily manifests as conductive or mixed hearing loss. Surgical treatment is the treatment of choice in patients with adequate cochlear reserve, with success rates, defined as an air-bone gap (ABG) closure and bone conduction (BC) change ≤10 dB, ranging from 67% to 94%. However, as the disease is progressive, sensorineural hearing loss may persist or progress, requiring subsequent auditory rehabilitation.
Objective: to evaluate hearing outcomes in patients aged ≥65 years who underwent stapes surgery.
Materials and methods: observational, retrospective, descriptive study. Sixty-three patients (72 ears) diagnosed with otosclerosis who underwent surgery between January 2004 and December 2024 were included. Demographic variables and pre- and postoperative audiological parameters were analyzed, including ABG, bone conduction (BC), and pure-tone average (PTA) at frequencies of 0.5, 1, 2, and 4 kHz.
Results: of the patients, 58.7% were women (female-to-male ratio, 1.4:1). Mixed hearing loss was present in 98.6% of patients. Bilateral involvement was observed in 52.3% of cases. ABG closure ≤10 dB was achieved in 85.4% of ears, and a BC change ≤10 dB was achieved in 85%. The PTA showed a mean improvement of −26.25 dB for air conduction and −6.25 dB for bone conduction. Mean follow-up was 7.9 years. Postoperatively, 22% of patients required hearing aids. Minor complications occurred in 9.52% of cases.
Conclusion: stapes surgery in patients aged over 65 years is an effective and safe procedure, with high rates of audiological success and a low incidence of complications, constituting a valid therapeutic option for this age group.
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