Predictive factors in 995 stapes surgeries for primary otosclerosis.

Objectives/hypothesis: This study sought to identify the predictors of outcome in patients with otosclerosis undergoing primary stapes surgery.

Study Design: Retrospective analysis of medical records.

Methods: A total of 995 patients with otosclerosis who underwent primary stapes surgery by a single surgeon between January 2006 and December 2016 were included. Logistic regression analysis was performed to examine factors affecting postoperative hearing thresholds at individual frequencies. A postoperative air-bone gap (ABG) closure ≤ 10 dB in the stapes surgery was considered as excellent outcome.

Results: Stapedotomies and stapedectomies were conducted in 823 and 172 ears, respectively. The surgeries had an overall success rate of 93.6%. Univariate analysis showed a significantly higher success rate in patients with larger prostheses (diameter = 0.6 mm). According to the results of multivariate logistic regression analysis, preoperative ABG (B coefficient = -0.10), bilaterality (odds ratio [OR] = 2.09), right ear involvement (OR = 2.00), female gender (OR = 1.81), and nonobliterative footplate (OR = 3.69) were significant prognostic factors predicting excellent outcome.

Conclusions: Our findings indicated that the functional results were generally good. Based on logistic regression analysis, preoperative ABG and nonobliterative footplate were the most important predictors of hearing outcome after stapes surgery for otosclerosis. The success of the surgery did not depend on the procedure types (stapedotomy vs. stapedectomy) or the diameter of the prosthesis (0.4 mm vs. 0.6 mm).

Level Of Evidence: 4. Laryngoscope, 128:2403-2407, 2018.