Jellema Maaike, Blijleven Esther E, Buwalda Joeri, Hemler Raphael J B, van Waegeningh Huib F, Stokroos Robert J, Wegner Inge, Thomeer Henricus G X M
Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
Otolaryngol Head Neck Surg. 2025 Sep;173(3):697-704. doi: 10.1002/ohn.1298. Epub 2025 May 9.
This study evaluated outcomes of stapes surgery in otosclerosis patients by assessing audiometric results and health-related quality of life (HRQOL) using the Dutch Stapesplasty Outcome Test-25 (SPOT-25) questionnaire. Additionally, the role of SPOT-25 in preoperative decision-making and as a follow-up tool was explored.
A prospective, multicenter cohort study.
One tertiary academic medical center and 3 secondary referral centers.
Data from 115 adult patients undergoing primary stapes surgery was analyzed. Audiometric outcomes were measured using pure-tone audiometry results and word recognition score (WRS). HRQOL was assessed using SPOT-25, Glasgow Health Status Questionnaire, and Glasgow Benefit Inventory. Pre- and postoperative outcomes were compared, and correlations between pure-tone audiometry results, WRS, and HRQOL were analyzed. Outcomes were compared between patients receiving 0.4 and 0.6 mm diameter pistons, and the impact of preoperative pure-tone audiometry results was analyzed.
Significant postoperative improvements were observed in all audiometric measures (mean air conduction gain of 22 dB and air-bone gap (ABG) improvement of 18 dB). HRQOL also improved significantly (mean SPOT-25 score improved from 48 to 27). The 0.6 mm piston group had a significantly smaller postoperative ABG than the 0.4 mm group. Patients with a preoperative ABG ≤ 15 dB had a mean SPOT-25 gain of 19 (SD 22), whereas those with a preoperative ABG > 15 dB had a gain of 21 (SD 18).
Stapes surgery significantly improves hearing and HRQOL. The SPOT-25 is a valuable tool for evaluating HRQOL and may assist in preoperative decision-making in patients with varying hearing impairments.
III.
本研究通过使用荷兰镫骨成形术结果测试-25（SPOT-25）问卷评估听力测定结果和健康相关生活质量（HRQOL），来评估耳硬化症患者镫骨手术的疗效。此外，还探讨了SPOT-25在术前决策和作为随访工具中的作用。
一项前瞻性、多中心队列研究。
一家三级学术医疗中心和3家二级转诊中心。
分析了115例接受初次镫骨手术的成年患者的数据。使用纯音听力测定结果和单词识别分数（WRS）来测量听力测定结果。使用SPOT-25、格拉斯哥健康状况问卷和格拉斯哥益处量表来评估HRQOL。比较术前和术后结果，并分析纯音听力测定结果、WRS和HRQOL之间的相关性。比较接受直径0.4和0.6毫米活塞的患者的结果，并分析术前纯音听力测定结果的影响。
所有听力测定指标术后均有显著改善（平均气导增益22dB，气骨导间距（ABG）改善18dB）。HRQOL也有显著改善（平均SPOT-25分数从48提高到27）。0.6毫米活塞组术后ABG明显小于0.4毫米组。术前ABG≤15dB的患者平均SPOT-25增益为19（标准差22），而术前ABG>15dB的患者增益为21（标准差18）。
镫骨手术显著改善听力和HRQOL。SPOT-25是评估HRQOL的有价值工具，可能有助于不同听力障碍患者的术前决策。
III级。
