Predictors of listening capabilities and patient satisfaction after stapes surgery in otosclerosis.

ABSTRACT

OBJECTIVE: To study objective or subjective preoperative factors predicting improvement in listening capabilities and patient satisfaction after stapes surgery in otosclerosis. STUDY DESIGN: Prospective, multicenter study. SETTING: Two tertiary referral centers. PATIENTS Fifty-four consecutive adult patients with otosclerosis. INTERVENTIONS: Stapedotomy, stapedectomy. MAIN OUTCOME MEASURES: Pure tone and speech audiometry and questionnaires were assessed preoperatively and repeated 6 months postoperatively. The questionnaires consisted of a visual analogue scale (VAS, 0-10) to score the overall quality of life, and the Operation Benefit Profile to assess the listening capability in various circumstances. Stereophony, defined by the Belfast rule of thumb, was used to divide the patients in 3 categories having unilateral, symmetric bilateral, or asymmetric bilateral hearing loss. RESULTS: Six patients were considered early failures of surgery, and 8 patients were lost to follow-up. In the remaining 40 patients (43 ears), all audiometric parameters improved significantly. The postoperative air-bone gap was less than 10 dB in 70%. The postoperative average air conduction threshold was less than 30 dB in 49%. The postoperative quality of life was excellent (VAS, ≥9) in 45% and did not correlate with any preoperative parameter. Preoperative and postoperative overall listening capabilities correlated slightly (Spearman r, 0.47). The postoperative VAS correlated with all postoperative audiometric parameters and the Operation Benefit Profile. CONCLUSION: Uncomplicated stapes surgery itself is the only predictor of improvement in listening capabilities and patient satisfaction 6 months after stapes surgery in otosclerosis.