Management of Far-Advanced Otosclerosis: Stapes Surgery or Cochlear Implant

Özet

Objective: The aim of this report is to share our experience and treatment outcomes with far-advancedotosclerosis (FAO) patients.Methods: Patients that underwent surgery from 2003through 2014 at a tertiary referral center were retrospectively reviewed. Nineteen FAO patients were included in the study. Audiological results and the ability to communicate face to face and over telephonewere considered as the main outcome measures.Results: Six FAO patients benefited well from stapedotomy with an average of 5.9-decibel (dB) air-bonegap and 86% median speech discrimination. Cochlearimplantation (CI) was performed in 13 patients; twohad disease progression after stapedotomy, five hadfailed stapes surgeries elsewhere, and six preferred CIas primary treatment. Median speech discriminationscore of CI patients was 78.4%. Overall, all patientshad satisfactory face-to-face communication and 90%could use telephone.Conclusion: Bilateral stapedotomy and wearinghearing aid is an effective and cost-effective solutionfor restoring natural binaural hearing and requires nospecific training. Should stapedotomy fail, cochlearimplantation is always a successful back-up option.