Association Between the Duration of Hearing Loss and Hearing Outcomes in Surgery for Otosclerosis

Abstract

Introduction Hearing loss due to otosclerosis is effectively treated with surgery. The association between duration of hearing loss and surgical outcomes is unknown. Study Design Retrospective review. Setting Large otology referral center. Methods Patients undergoing primary stapes surgery for otosclerosis from 2005 to 2017 were evaluated according to their self-reported duration of hearing loss. Closure of the air-bone gap (ABG) was the primary outcome measure. Results A total of 580 stapes operations were included. Sixteen percent of patients reported hearing loss for ≤1 year; 25%, >1 to ≤5 years; 24%, >5 to ≤10 years; 24%, >10 to ≤20 years; and 12%, >20 years, respectively. Average pre- and postoperative ABGs were 26.1 and 9.6 dB ( P < .0005). Patients with longer duration of hearing loss had worse preoperative ABGs ( P < .0005). After surgery, patients with longer duration of hearing loss had a greater reduction in their ABGs ( P < .0005) such that the remaining ABG was not associated with duration of hearing loss ( P > .05). There were no significant associations between the duration of hearing loss and complication rates or the need for revision surgery. Conclusion Otosclerosis is effectively treated with surgery even after a long duration of hearing loss, provided that sensorineural hearing and word recognition are favorable. Although far-advanced otosclerosis has known poorer hearing outcomes after stapes surgery, a long duration of hearing loss is an unreliable surrogate for this.