Université Catholique de Louvain, ENT Department, Mont-Godinne University Hospital, Yvoir, Belgium.
Audiology Department, Institut Libre Marie-Haps, Brussels.
Otol Neurotol. 2021 Dec 1;42(10):e1436-e1443. doi: 10.1097/MAO.0000000000003332.
To describe the 151 hearing results of primary stapedotomy for otosclerosis using different criteria of success rates.
Retrospective case series of 151 patients with a diagnosis of otosclerosis and operated on by the same surgeon with the same technique, using a CO2 laser. Patients with revision surgery were excluded. The audiometric data were extracted from the patient files and divided into three groups: early postoperative follow-up (<1 mo after surgery), mid-term follow up (between 1 mo and 1 yr), and late postoperative follow-up (>1 yr).
The postoperative air-bone gap (ABG) was 10 dB or less in 45.2% in the mid-term follow up. For this same follow-up, ABG closure less or equal than 20 dB was achieved in 95.6% of cases. The lower percentage of patients with a postoperative ABG closure of less than or equal to 10 dB can be due to the high rate of bone conduction (BC) overclosure of 15.65%. The functional success described as an air conduction (AC) threshold less than or equal to 30 dB was achieved in 52.2% of patients. The mean speech reception threshold (SRT) in the mid-term follow up was 27.4 dB. The analysis of the data according to the Amsterdam Hearing Evaluation Plots (AHEPs) shows a success rate of 87% at early follow-up.
The success rate is mainly dependent on the definition and criteria as a measure of success. An analysis of the evolution of the BC is mandatory to avoid a false positive success rate when the ABG closure is used. Therefore, the use of the AHEPs would acquire additional information. The hearing outcome has also been based on the speech audiometry and the number of patients achieving an AC less than or equal to 30 dB as a more realistic measure of success. Our series confirms good long term hearing results achieved in stapedotomy surgery with the CO2 laser.
描述使用不同成功率标准的原发性镫骨切开术治疗耳硬化症的 151 例听力结果。
对 151 例经同一术者采用 CO2 激光行相同技术镫骨切开术诊断为耳硬化症的患者进行回顾性病例系列研究，排除翻修手术患者。从患者档案中提取听力数据，并将其分为三组：术后早期随访（术后 1 个月内）、中期随访（1 个月至 1 年）和术后晚期随访（>1 年）。
中期随访时，术后气骨导差（ABG）为 10dB 或以下的患者占 45.2%。对于相同的随访，95.6%的病例达到了 ABG 关闭值小于或等于 20dB。术后 ABG 关闭值小于或等于 10dB 的患者比例较低，可能是由于骨导过度闭合率为 15.65%较高。描述为气导阈值小于或等于 30dB 的功能成功率为 52.2%。中期随访时的平均言语接受阈（SRT）为 27.4dB。根据阿姆斯特丹听力评估图（AHEPs）对数据的分析显示，早期随访时的成功率为 87%。
成功率主要取决于定义和标准作为成功的衡量标准。分析骨导的演变对于避免使用 ABG 关闭值时出现假阳性成功率是必要的。因此，使用 AHEPs 将获得额外的信息。听力结果还基于言语测听和达到气导小于或等于 30dB 的患者数量，这是更现实的成功衡量标准。我们的系列研究证实，CO2 激光镫骨切开术可获得良好的长期听力效果。
