Evaluating the benefits and outcomes of second ear surgeries in bilateral stapedectomies: a comprehensive analysis

Sheetal K.; Preethi R.; B. A. Abhilash; Divya M. B.

doi:10.18203/issn.2454-5929.ijohns20241323

Authors

Sheetal K. Department of Otorhinolaryngology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Maduranthakam, Tamil Nadu, India
Preethi R. Department of Otorhinolaryngology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Maduranthakam, Tamil Nadu, India
B. A. Abhilash Department of Community Medicine, Government Medical College, Ariyalur, Tamil Nadu, India
Divya M. B. Department of Otorhinolaryngology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Maduranthakam, Tamil Nadu, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20241323

Keywords:

Otosclerosis, Obliterative foot plate, Facial nerve anomalies, Audiological outcome, Binaural symmetric hearing, Bilateral stapedectomy

Abstract

Background: Objectives of the study were to evaluate the anatomical abnormalities and benefits of second ear surgery in patients with bilateral otosclerosis undergoing stapedectomy.

Methods: A descriptive retrospective study was done in 43 patients undergoing bilateral stapedotomy in a tertiary care centre. Anatomical abnormalties presenting intraoperative were recorded in both operated ears. Hearing outcomes after the first and second ear surgeries were recorded. Chi square and paired t test was used to find the association between categorical and continuous variables between both groups. We correlated the post-operative air conduction (AC) averages, air bone gap (ABG) gain, AC gain between first and second operated ears.

Results: Obliterative FP was the most common abnormality seen 7%, followed by facial nerve anamolies 5%. Bilateral variations were seen in 66% and 60% respectively. 66% required bilateral drill outs. After 1st ear and 2nd ear surgery 81% and 76% gained normal hearing. Average postop AC threshold was significantly higher after first ear surgery (p<0.001). ABG and AC gain had no significant difference in both ears. Binaural symmetrical hearing with inter aural difference AB<10 dB was achieved in 90% of patients.

Conclusions: It is worthwhile to recommend the patients to undergo contralateral ear surgery if the first ear had achieved normal or socially acceptable hearing, as the chances of achieving a comparable hearing outcome as that of 1st ear is high. Following 2nd ear surgery an effective binaural symmetric hearing can be achieved.

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