Department of Neurotology, Michigan Ear Institute, Farmington Hills, Michigan, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Otolaryngol Head Neck Surg. 2021 May;164(5):1094-1099. doi: 10.1177/0194599820964726. Epub 2020 Oct 13.
Hearing loss due to otosclerosis is effectively treated with surgery. The association between duration of hearing loss and surgical outcomes is unknown.
Retrospective review.
Large otology referral center.
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.
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 ( < .0005). Patients with longer duration of hearing loss had worse preoperative ABGs ( < .0005). After surgery, patients with longer duration of hearing loss had a greater reduction in their ABGs ( < .0005) such that the remaining ABG was not associated with duration of hearing loss ( > .05). There were no significant associations between the duration of hearing loss and complication rates or the need for revision surgery.
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.
耳硬化症导致的听力损失可以通过手术有效治疗。听力损失持续时间与手术结果之间的关系尚不清楚。
回顾性研究。
大型耳科学转诊中心。
根据患者自我报告的听力损失时间，评估 2005 年至 2017 年间因耳硬化症接受初次镫骨手术的患者。听力气骨导差（ABG）的闭合是主要的观察指标。
共纳入 580 例镫骨手术。16%的患者报告听力损失时间≤1 年；25%，>1 至≤5 年；24%，>5 至≤10 年；24%，>10 至≤20 年；12%，>20 年。平均术前和术后 ABG 分别为 26.1 和 9.6dB（<0.0005）。听力损失持续时间较长的患者术前 ABG 较差（<0.0005）。手术后，听力损失持续时间较长的患者 ABG 下降幅度更大（<0.0005），以至于剩余 ABG 与听力损失持续时间无关（>0.05）。听力损失持续时间与并发症发生率或需要翻修手术之间无显著相关性。
即使听力损失持续时间较长，耳硬化症仍可通过手术有效治疗，前提是感音神经性听力和言语识别能力良好。尽管进展期耳硬化症的镫骨手术后听力结果较差，但听力损失持续时间并不可靠地预测这种情况。
