Long-Term Audiometric Outcomes of a Self-Crimping Stapes Prosthesis With CO 2 Laser Stapedotomy

Abstract

Objective: To evaluate our experience with a self-crimping stapes prosthesis.

Study design: Retrospective case review.

Setting: Tertiary referral center.

Patients: All patients diagnosed with otosclerosis who underwent surgery between June 2013 and June 2020. Inclusion criteria were 18 years or older, isolated stapes ankylosis, and at least 1 year of postoperative audiologic data.

Interventions: CO 2 laser stapedotomy undertaken by the same surgeon using the same CO 2 laser stapedotomy technique and the same prosthesis.

Main outcome measures: Preoperative and postoperative audiologic data including air-bone gap (ABG) measurements, average speech discrimination score and pure-tone averages (PTAs). Postoperative hearing assessments were performed at 3 weeks, 3 months, 6 months, 1 year, and annually thereafter.

Results: Two hundred fourteen patients were included in the study, of whom 17 had bilateral sequential surgery for a total of 231 ears. Mean preoperative air conduction-PTA was 58.8 dB and mean preoperative bone conduction-PTA 24.2 dB, a preoperative ABG of 34.6 dB. One year postoperatively, mean air conduction-PTA improved to 31.2 dB ( p < 0.0001). ABG showed a significant improvement from 34.6 to 5.5 dB ( p < 0.0001). Closure of the ABG to within 10 dB was achieved in 87% ears at 3 months, in 91% at 6 months, and in 93% at 1 year. There was no significant difference in preoperative and postoperative average speech discrimination score.

Conclusion: The current study demonstrates favorable audiologic outcomes in a large cohort of patients using a self-crimping stapes prosthesis. These results were stable for up to 7 years on follow-up.