2023 Volume 116 Issue 6 Pages 537-543
We present, herein, the hearing results of 112 cases of stapes surgery for otosclerosis (75 ears), congenital ossicular malformation (18 ears), and tympanosclerosis (19 ears).
According to the statement of the Otological Society of Japan and the guideline of the American Academy of Otolaryngology Head and Neck Surgery Foundation (AAO), the success rate for hearing improvement after stapes surgery is the highest for otosclerosis, followed by congenital ossicular malformation, and then tympanosclerosis, in that order.
The success rate for hearing improvement is 93.3% for otosclerosis, 83.3% for ossicular malformation, and 52.6% for tympanosclerosis, according to the statement of the Japan Otological Society.
The success rate for cases with a postoperative air-bone gap of less than 10 dB is 72% for otosclerosis, 38.9% for ossicular malformation, and 21.1% for tympanosclerosis, according to the guideline (AAO).
Analysis of variance revealed a significant difference in the postoperative air-bone gap between case of otosclerosis and ossicular malformation, as between those of otosclerosis and tympanosclerosis; however, the postoperative air-bone gap was not significantly different between cases of ossicular malformation and tympanosclerosis. The inferior hearing results in cases of congenital ossicular malformation and tympanosclerosis were considered as being probably attributable to the higher degree of difficulty of the surgery. These two groups had morphological deformities, such as the absence of the long process of the incus, severe rigidity of the footplate of stapes, and absence of the oval window, which led to difficult surgery, and postoperative re-fixation of the ossicles was often seen in cases tympanosclerosis.
The incidence of severe dizziness as a complication of stapes surgery was also examined. When severe dizziness occurred immediately after stapedectomy, computed tomography often revealed pneumolabyrinth. This pneumolabyrinth with evidence of perilymphorrhea continued to persist in case with persistent dizziness. However, while the size and duration of the pneumolabyrinth did not lead to worsening of the hearing results, pneumolabyrinth accompanied by protrusion of the prosthesis into the labyrinth made the hearing worse.
