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Effect of cochlear reserve on postoperative outcome in otosclerosis

Effect of cochlear reserve on postoperative outcome in otosclerosis Patients with elevated bone conduction (BC) thresholds are not considered a good candidate for otosclerosis surgery. Sometimes, it might be difficult to decide to operate these patients considering relatively poor cochlear function. However, viewpoints may vary among otologists. This study was undertaken to compare hearing outcome following otosclerosis surgery in patients who had bone conduction (BC) thresholds ≥ 30 dB, and to investigate whether BC thresholds >30 dB has a negative impact on hearing outcome. Medical records of 111 patients who had undergone otosclerosis surgery were reviewed. Of 111 patients, 83 had undergone stapedotomy, and 28 stapedectomy. The patients were grouped based on preoperative four-tone BC threshold. Eighty-seven patients had average BC threshold ≤ 30 dB, and were assigned to good-cochlear reserve group. The remaining 24 patients had average BC > 30 dB, and constituted poor-cochlear reserve group. Pre- and postoperative air conduction (AC) and BC thresholds, air-bone (AB) gap, vocal audiometry results and amount of deterioration in BC were determined. Mean postoperative AB gap was almost the same in both groups (14 and 15 dB) ( P > 0.05). Percentage of AB gap = 10 dB favored good-cochlear reserve group (41 vs 29%)( P > 0.05). Analysis of mean hearing gain was slightly in favor of good-cochlear reserve group (19 vs 15 dB) ( P > 0.05). Better BC thresholds were obtained postoperatively in good-cochlear reserve group ( P < 0.001). Deterioration > 10 dB in BC was observed in 5.7 and 12.5% of the patients with good- and poor-cochlear reserve, respectively ( P > 0.05). Based on the results of this small sample-size study, even though BC threshold of 30 dB was not considered a negative factor for hearing gain, otosclerosis surgery might have detrimental effects on postoperative BC thresholds in patients who had BC thresholds >30 dB. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Archives of Oto-Rhino-Laryngology Springer Journals

Effect of cochlear reserve on postoperative outcome in otosclerosis

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References (10)

Publisher
Springer Journals
Copyright
Copyright © 2007 by Springer-Verlag
Subject
Medicine & Public Health; Head and Neck Surgery; Neurosurgery ; Otorhinolaryngology
ISSN
0937-4477
eISSN
1434-4726
DOI
10.1007/s00405-006-0205-9
pmid
17093996
Publisher site
See Article on Publisher Site

Abstract

Patients with elevated bone conduction (BC) thresholds are not considered a good candidate for otosclerosis surgery. Sometimes, it might be difficult to decide to operate these patients considering relatively poor cochlear function. However, viewpoints may vary among otologists. This study was undertaken to compare hearing outcome following otosclerosis surgery in patients who had bone conduction (BC) thresholds ≥ 30 dB, and to investigate whether BC thresholds >30 dB has a negative impact on hearing outcome. Medical records of 111 patients who had undergone otosclerosis surgery were reviewed. Of 111 patients, 83 had undergone stapedotomy, and 28 stapedectomy. The patients were grouped based on preoperative four-tone BC threshold. Eighty-seven patients had average BC threshold ≤ 30 dB, and were assigned to good-cochlear reserve group. The remaining 24 patients had average BC > 30 dB, and constituted poor-cochlear reserve group. Pre- and postoperative air conduction (AC) and BC thresholds, air-bone (AB) gap, vocal audiometry results and amount of deterioration in BC were determined. Mean postoperative AB gap was almost the same in both groups (14 and 15 dB) ( P > 0.05). Percentage of AB gap = 10 dB favored good-cochlear reserve group (41 vs 29%)( P > 0.05). Analysis of mean hearing gain was slightly in favor of good-cochlear reserve group (19 vs 15 dB) ( P > 0.05). Better BC thresholds were obtained postoperatively in good-cochlear reserve group ( P < 0.001). Deterioration > 10 dB in BC was observed in 5.7 and 12.5% of the patients with good- and poor-cochlear reserve, respectively ( P > 0.05). Based on the results of this small sample-size study, even though BC threshold of 30 dB was not considered a negative factor for hearing gain, otosclerosis surgery might have detrimental effects on postoperative BC thresholds in patients who had BC thresholds >30 dB.

Journal

European Archives of Oto-Rhino-Laryngology – Springer Journals

Published: May 1, 2007

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