Analysis of long-term hearing gains after stapes surgery with piston reconstruction for otosclerosis

Abstract

<h4>Objectives</h4>We sought to assess the postoperative hearing gains at individual frequencies after stapes surgery with piston reconstruction for clinical otosclerosis.<h4>Methods</h4>We analyzed the air conduction (AC) hearing gains at various audiometric frequencies in a sample of 1,168 stapes procedures with piston reconstruction performed on 911 strictly consecutive patients by one surgeon between 1963 and 1979. Assiduous follow-up of patients was attempted for at least 10 years. The audiometric results over time were stored for computer analysis.<h4>Results</h4>The mean AC gain over the speech frequencies (0.5, 1,2, and 3 kHz) was 35.5 dB at 1 year after operation, and the rate of deterioration over the next 19 years was 0.58 dB/y.<h4>Conclusions</h4>The picture to emerge from the analysis is clear. The mean AC gain is maximal at nearly 40 dB for the audiometric frequencies of 0.25, 0.5, and 1 kHz. The mean AC gain at any given time after operation decreases with increasing frequency, at least for frequencies of > or = 1 kHz. For any frequency there is, with few exceptions, a significant decrease in the AC gain from one time period to the next.