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Context: Stapes surgery is the mainstay of treatment for  otosclerosis. Reported success rates of stapes surgery for  otosclerosis vary widely, ranging from 63.6% to 94%. The  pre-operative prognostic factors of hearing outcomes after  surgery are not well studied. Objective: To determine the hearing results after stapes  surgery and analyze the prognostic role of pre-operative  factors on hearing outcomes. Design: Retrospective study. Setting: Tertiary referral center. Patients: 90 cases of otosclerosis operated on in our  institute from 2006 to 2016 were included into the study. Interventions: Stapes surgery was performed for 90 cases of  otosclerosis (77 stapedotomies, 13 stapedectomies). Main outcome measures: Audiograms performed just  before and six months after operation were used. We  selected several pre-operative variables for analysis- age,  gender, unilateral/bilateral disease, air (AC) and bone  conduction (BC) thresholds, air-bone gap (ABG). Our  outcomes measured were post-operative AC, ABG and  percentage improvement in air-bone gap (ABGi). The  associations between these pre-operative predictors and  outcomes were then analyzed. Results: We report 80% (n=72) and 84.7% (n=76) of cases  achieving ideal ABG (≤ 10 dB) and AC outcomes (gain in ≥ 20  dB), respectively. The mean post-operative ABG was 8.8 dB.  The mean ABGi, was 78.8% with 78.9% (n=71) of cases  attaining ideal ABGi (≥ 70%). Pre-operative variables did not  significantly influence post-operative AC and ABG results.  However, patients with larger pre-operative ABG (>30 dB)  had greater ABGi (85.7 vs. 72.5%, p<0.001). Conclusion: Stapes surgery provides good and predictable  results independent of disease severity or patient profile. Consequently, patients with larger hearing impairment are  likely to benefit relatively more from surgery.

A Retrospective Study: Good Functional Outcomes are Independent of Pre-Operative Factors in Stapes Surgery for Otosclerosis