Long-term Results after Stapes Surgery for Otosclerosis

In a retrospective study, hearing results before and after stapedectomy were compared with those of individuals not undergoing surgery. Subjects were 51 patients who were surgically diagnosed as having otosclerosis and who could be followed up for more than 5 years. Of these, 31 contralateral ears surgically diagnosed as otosclerotic did not undergo surgery (nonsurgery group). Nineteen ears underwent stapedectomy using a wire loop prosthesis (TS group). Thirty-eight ears underwent stapedotomy using a wire piston prosthesis (SFS group). In the nonsurgery ear group, the last air conduction threshold deteriorated equally at all frequencies. Deterioration of the high frequency air conduction threshold seemed to cause deterioration of the bone conduction threshold. Deterioration of the last air conduction threshold in the SFS group was somewhat less than that in the TS group, although not significantly. In patients up to 50 years old, the air conduction loss/year in the SFS group was significantly less than that in the nonsurgery ear group at 0.25 kHz and 0.5 kHz. The bone conduction loss/year in the SFS group was less than that in both the TS group and nonsurgery ear group at 1 kHz. No significant differences was seen in either air or bone conduction loss/year among the 3 groups in patients 51 years or older. We concluded that stapedotomy and wire piston prosthesis are the surgical techniques of choice in the treatment of otosclerosis.