Audiological outcome and surgical findings in patients with bilateral surgery for otosclerosis

Abstract

Introduction: Despite the advantages of binaural hearing, surgical management of the second ear in patients with bilateral otosclerosis was for years a controversial topic due to the risk of sensorineural hearing loss.

Aim: To describe the surgical and audiological results of patients with bilateral surgeries for otosclerosis in our hospital between 1988-2011. Material and method: Retrospective study based on clinical charts revision. Results: 13.5% of the 415 patients underwent bilateral surgery. The average age was 44.2 ± 7.7 (men) and 42.0 ±10.4 years (women). There was a 33.6 dB improvement in average air-conduction hearing thresholds in the first surgery and 29.2 dB for the second, while the mean bone-conduction improved 7.0 and 3.0 dB for the first and second surgery correspondingly. The surgical difficulties found in the first and second surgeries were, respectively: floating platens 0% and 2.5%, obliterated platens 5.4% and 5.1%, deep niche 5.4% and 0%, facial overhang 38.5% and 43.2%, dehiscent facial 18.2% and 13.8% and chorda tympani section 2% and 5.7%. Discussion: Hearing results for the second ear were comparable to the first surgery. This, together with the absence of significant complications, supports a bilateral surgical approach. Conclusion: Surgery of the second ear in bilateral hypoacusia due to otosclerosis has proven to be a safe and reliable alternative.