Otosclerosis. Histopathological features and stapedostomy hearing results

Abstract

Introduction: Otosclerosis causes conductive hearing loss that histologically corresponds to a bone remodeling process called otoespongiosis. Although multiple pathological studies describing onset and the characteristics of this process, there are no articles in literature that correlate histological disease with hearing impairment and surgical outcomes. Aim: Correlate pathological disease with clinical, intraoperative and audiometric va­riables and evaluate the stapedostomy outcome. Material and method: Retrospective study including patients undergoing stapedostomy between 1995 and 2011, with histopathologic evaluation of stapes bone and pre and postoperative audiometric evaluation. Statistically, univariate analysis for categorical and continuous variables was used, then a logistic model to identify predictors of surgical success was adjusted. For data tabulation and analysis Stata^®12 (StataCorp. 2011. College Station, TX: StataCorp LP) statistical software was used. Results: 204 stapedectomies were assessed, 24.51% with abnormal stapes bones, the gross appearance of the stage was not related to the microscopic result (p =0.476), no association between pre-surgical air audiometric thresholds (p =0.291) and bone (p =0.824) with histopathologic severity was found. The improved postoperative airway threshold (p =0.326) and air-bone gap closure (p =0.23) did not correlate with histology. Conclusion: Stapedostomy primary outcome, ie, improvement in hearing thresholds, as well as the air-bone gap, were significant. Routine pathological stapes bone study had no prognostic value in contrast to other factors analyzed in this study.