Prognostic indicators of Stapedectomy in tympanosclerosis

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Yıldırım N., Varol M., Akbal S.

5th International Symposium on Otosclerosis and Stapes Surgery, Brussels, Belgium, 19 - 21 April 2023

  • Publication Type: Conference Paper / Unpublished
  • City: Brussels
  • Country: Belgium
  • Kütahya Health Sciences University Affiliated: Yes

Abstract

Background: Tympanosclerosis is characterized with mineral deposition within the middle ear mucosa and eardrum. According to the most widely used classification (by Weilinga and Kerr) tympanosclerosis  is divided into four grades of which 3. and 4. grades include stapes fixation. Surgical treatment of tympanosclerotic stapes fixation has been controversial. We herewith present the middle/long-term surgical results of our tympanosclerosis cases with stapedial fixation as to evaluate its prognostic indications.

 

Method: Thirty-seven ears of 33 patients, who operated between  2015 and 2023 for tympanosclerotic stapes fixation made up our cohort. We reviewed the patients’ records including operation reports, pre-and post-operative audiograms and they were called for the assessment of current condition of the ears, if not regularly followed-up. The age of the patients (stratified), the condition of ossicles and joints (according to Weilenga-Kerr (W-K) grading), and staging the stapedial interventions (1st, 2nd stages, revisions ) were taken as variables for the final assessments.   

 

Results: The median age of the patients were 40. The number of under 21, 22-40 and over 41 age-groups were 5, 12 and 16 respectively.  In 28 (75.67%) of the ears, ossiculoplasties including stapedotomies/stapedectomies were done at the same session, 9 (24.3%) ears stapedeotomy-including ossiculoplasties were at the second stage as they had undergone tympanoplasties for eardrum perforations previously. Five of the stapedectomies  had to be revised . Under 20 dBHL air-bone gap (ABG) were achieved in 14 (37.8%) of the ears and the best results were attained in the “under 21” age group with 62.5% . Weilinga-Kerr grade-3 ears had better outcomes than the W-K-4 ears . Staging of ossiculoplasties did not seem to affect the final outcome significantly. In three of the ears hearing was deteriorated over the months.

 

Conclusion: Of the  prognostic indicators, the ages of the patients and the extensiveness of the tympanosclerotic process appeared to outstand.     

 

 

Keywords: tympanosclerosis, stapedectomy, ossiculoplasty, hearing gain