Otosclerosis: thirty-year follow-up after surgery.

Objectives: The aims of this study were to evaluate the hearing outcomes 28 to 30 years after stapedectomy in patients with surgically confirmed otosclerosis, and to evaluate inner ear involvement.

Methods: A retrospective clinical study was performed. Sixty-five consecutive patients who underwent stapedectomy at a tertiary referral center between 1977 and 1979 were included in the study. Medical records, including preoperative and postoperative audiograms, were reviewed, and a long-term follow-up clinical examination and pure tone audiometry were performed. The hearing outcome was compared with that of a reference population (ISO 7029) in terms of age and gender.

Results: Thirty years after stapedectomy, 66% of the patients' ears studied showed a moderate to profound hearing loss. The deterioration was mainly caused by a sensory hearing loss. The hearing loss was significantly greater than that in the reference population for both air and bone conduction thresholds at the early and late stages of the disease. A large majority of the patients (88%) had bilateral otosclerosis.

Conclusions: Patients with otosclerosis have a sensorineural hearing loss that cannot be explained by age. Otosclerosis should be regarded as a middle and inner ear disease. Almost all patients with otosclerosis are in need of ongoing audiological rehabilitation and hearing aids.