Does stapedotomy improve high frequency conductive hearing?

Autor: Roychowdhury P; Department of Otolaryngology-Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA.; Department of Otolaryngology University of Massachusetts Medical School Worcester Massachusetts USA., Polanik MD; Department of Otolaryngology-Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA.; Department of Otolaryngology University of Massachusetts Medical School Worcester Massachusetts USA., Kempfle JS; Department of Otolaryngology-Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA.; Department of Otolaryngology UMASS Memorial Medical Center Worcester Massachusetts USA., Castillo-Bustamante M; Department of Otolaryngology-Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA.; Department of Otolaryngology Harvard University Boston Massachusetts USA., Fikucki C; Department of Audiology UMASS Memorial Medical Center Worcester Massachusetts USA., Wang MJ; Department of Otolaryngology University of Massachusetts Medical School Worcester Massachusetts USA., Kozin ED; Department of Otolaryngology-Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA.; Department of Otolaryngology Harvard University Boston Massachusetts USA., Remenschneider AK; Department of Otolaryngology-Head and Neck Surgery Massachusetts Eye and Ear Infirmary Boston Massachusetts USA.; Department of Otolaryngology University of Massachusetts Medical School Worcester Massachusetts USA.; Department of Otolaryngology UMASS Memorial Medical Center Worcester Massachusetts USA.; Department of Otolaryngology Harvard University Boston Massachusetts USA.; Department of Audiology UMASS Memorial Medical Center Worcester Massachusetts USA.
Jazyk: angličtina
Zdroj: Laryngoscope investigative otolaryngology [Laryngoscope Investig Otolaryngol] 2021 Jun 11; Vol. 6 (4), pp. 824-831. Date of Electronic Publication: 2021 Jun 11 (Print Publication: 2021).
DOI: 10.1002/lio2.599
Abstrakt: Objectives: Stapedotomy is performed to address conductive hearing deficits. While hearing thresholds reliably improve at low frequencies (LF), conductive outcomes at high frequencies (HF) are less reliable and have not been well described. Herein, we evaluate post-operative HF air-bone gap (ABG) changes and measure HF air conduction (AC) thresholds changes as a function of frequency.
Methods: Retrospective review of patients who underwent primary stapedotomy with incus wire piston prosthesis between January 2016 and May 2020. Pre- and postoperative audiograms were evaluated. LF ABG was calculated as the mean ABG of thresholds at 250, 500, and 1000 Hz. HF ABG was calculated at 4 kHz.
Results: Forty-six cases met criteria. Mean age at surgery was 54.0 ± 11.7 years. The LF mean preoperative ABG was 36.9 ± 11.0 dB and postoperatively this significantly reduced to 9.35 ± 6.76 dB, ( P  < .001). The HF mean preoperative ABG was 31.1 ± 14.4 dB and postoperatively, this also significantly reduced to 14.5 ± 12.3 dB, ( P  < .001). The magnitude of LF ABG closure was over 1.5 times the magnitude of HF ABG closure ( P  < .001). The gain in AC decreased with increasing frequency ( P  < .001).
Conclusion: Hearing improvement following stapedotomy is greater at low than high frequencies. Postoperative air bone gaps persist at 4 kHz. Further biomechanical and histopathologic work is necessary to localize postoperative high frequency conductive hearing deficits and improve stapedotomy hearing outcomes.
Level of Evidence: 4, retrospective study.
Competing Interests: The authors declare no conflicts of interest.
(© 2021 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)
Databáze: MEDLINE
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