Long-term outcomes of stapes surgery |
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| Institution: | 1. Department of Otorhinolaryngology, Head and Neck Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0374, Japan;2. School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa 252-0375, Japan;1. Department of Otolaryngology, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey;2. Department of Radiology, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey;3. Department of Pathology, Marmara University Pendik Training and Research Hospital, İstanbul, Turkey;1. Department of Otolaryngology-Head and Neck Surgery, Yokohama City University, Yokohama, Japan;2. Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA;3. Division of Head and Neck Surgery, University of California San Diego, La Jolla, California, USA;1. Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421 Japan;2. Department of Otorhinolaryngology, Koshigaya Municipal Hospital, 10-32, Higashikoshigaya, Koshigaya-shi, Saitama, 343-8577 Japan;3. Department of Neurology, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421 Japan;1. Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan;2. Department of Diagnostic Pathology, Kobe University Graduate School of Medicine, Kobe, Japan;3. Kobe City Medical Center General Hospital, Department of Pathology, Kobe, Japan;4. Institute of Liver Studies, King''s College Hospital & King''s College London, London, UK;1. Department of Otolaryngology, Kobe City Medical Center General Hospital, Kobe, Japan;2. Hearing Research Division, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan;3. Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan;4. Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan;5. Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;6. Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Japan;7. Laboratory of RNA Viruses, Department of Virus Research, Institute for Life and Medical Sciences, Kyoto University, Kyoto, Japan;8. Department of Infectious Diseases, Hiroshima University Hospital, Hiroshima, Japan |
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| Abstract: | ObjectiveHearing improvement following stapes surgery is generally good; however, we sometimes encounter patients where hearing loss gradually progresses over the long term. In this study, we investigated the causes of hearing loss in these cases.MethodsA total of 30 ears from 23 patients, who underwent stapes surgery at Kitasato University Hospital from 2001 to 2021 and were followed up for ≥5 years, were included in the study. Changes in air conduction (AC) and bone conduction (BC) thresholds were measured, and hearing evaluation was performed by calculating the air–bone gap (ABG) at the mean of 4 frequencies. Cases with a postoperative ABG of ≤10 dB at 6 months after surgery were classified into the following groups according to their hearing changes at 5 years after surgery: Group A (no ABG increase of ≥10 dB and no AC threshold increase of ≥10 dB) and Group B (an ABG increase of ≥10 dB and an AC threshold increase of ≥10 dB). In groups A and B, we examined factors affecting long-term postoperative results. In addition, the patients who underwent reoperation were examined.ResultsThe AC thresholds 6 months and 5 years after surgery decreased significantly compared with those before surgery (p < 0.01); however, the BC thresholds 6 months and 5 years after surgery did not vary significantly from those before surgery (p > 0.05). Group A included 16 ears from 13 patients (53.3%), and Group B included 3 ears from 3 patients (10.0%). There were no significant differences in age, sex, surgical method, piston type, piston length, presence of incudostapedial joint subluxation, computed tomography findings, and preoperative ABGs between groups A and B (p > 0.05). A total of 6 reoperations were performed in 3 ears from 3 patients, and there were 5 operations with the platinotomy hole to be closed by bone regrowth and 3 operations with the narrowed long process of the incus.ConclusionIn 10.0% of the patients who underwent stapes surgery, the ABG improved 6 months after surgery; however, the AC threshold and ABG increased 5 years after surgery. Our findings suggested that piston displacement and the platinotomy hole to be closed by bone regrowth are possible causes of hearing loss in cases where hearing loss progresses in the long term after stapes surgery. |
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