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Stapes surgery in profound hearing loss due to otosclerosis.

OBJECTIVES: This study was designed to determine the effectiveness of stapes surgery in patients with profound hearing loss related to far-advanced otosclerosis and if improvement in hearing is sufficient to avoid the need for cochlear implantation.

STUDY DESIGN: Retrospective chart review.

METHODS: We retrospectively studied the charts of 16 patients who had stapes surgery in 1 or 2 ears between 2005 and 2010 for far-advanced otosclerosis. These patients were all candidates for a cochlear implant according to our institution's criteria but were offered stapes surgery first. Preoperative and postoperative audiologic data, surgical data, postoperative satisfaction, and telephone use were noted.

RESULTS: Sixteen patients were included, 3 of which had had bilateral surgery. Status of the oval window was evaluated at the time of surgery. Sixteen footplates had bipolar otosclerosis, and 3 had obliterative otosclerosis. Average gain in air-conduction threshold pure-tone average was 33 dB (range, 13-52 dB) and average gain in speech perception scores was 54.4% (range, 0%-93%); 94% of the patients were satisfied by the surgery, and 94% were able to use the phone postoperatively. Overall, 87% of the patients had sufficient improvement to no longer be candidates for cochlear implantation.

CONCLUSION: Stapes surgery in patients with profound hearing loss due to otosclerosis is safe and can restore enough hearing to make ears aidable and averting the need to consider cochlear implantation.

LEVEL OF EVIDENCE: 3, Retrospective series.

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