Improved Bone Conduction and Hearing Outcomes After Stapes Surgery for OtosclerosisOA

Objective:To evaluate the improvement in bone conduction(BC)thresholds after stapes surgery for otosclerosis,compare the outcomes of surgical techniques,and analyze the short-and long-term results to inform treatment strategies.Methods:We retrospectively reviewed data from 173 patients(188 ears)who underwent total stapedectomy,partial stapedectomy,or stapedotomy for otosclerosis between 2009 and 2024.Medical histories,preoperative evaluations,and operative records were analyzed,focusing on pre-and postoperative pure-tone audiometry.Results:Postoperatively,mean thresholds improved by 20.3 dB for air conduction(AC)and 2.0 dB for BC,leading to a mean air-bone gap(ABG)of 18.3 dB.An ABG of less than 10 dB was achieved in 79 ears(42.0%),and full ABG closure(ABG≤20 dB)was achieved in 145 ears(80.4%).Compared with the preoperative levels,the BC thresholds at 0.5,1,and 2 kHz improved by 1.3,3.7,and 4.9 dB,respectively.However,the 4-kHz BC threshold increased by 1.7 dB.Postoperative AC thresholds at 0.5-4 kHz decreased significantly by 27.1,26.5,18.3,and 9.2 dB,respectively(p<0.001).Conclusion:Stapes surgery significantly improved BC thresholds at 0.5,1,and 2 kHz in patients with otosclerosis,with resolution of the CN at 2 kHz,indicating correction of the CHL.Although a slight increase in the BC threshold was observed at 4 kHz,the overall AC threshold improvement and ABG closure were substantial.These findings highlight the clinical relevance of the postoperative BC threshold dynamics.Summary Significant findings of the study:Significant improvement in BC,AC thresholds,and ABG closure post-stapes surgery.Postoperative BC thresholds better reflect true inner ear function.Comparable outcomes across different surgical techniques.What this study adds:Provides comprehensive short-and long-term outcome comparisons across stapes surgery techniques.Demonstrates consistent hearing improvements over time,supporting reliable patient outcomes.Identifies specific frequency improvements and limitations,guiding better surgical decision-making.