Delaying partial stapedectomy for otosclerosis: effects on long-term hearing outcomes following surgery

The purpose of this study is to evaluate hearing outcomes following partial stapedectomy according to age at the time of surgery and evaluate functional hearing at ≥10 years’ follow-up, and to assess the effect of delay in surgery on overall functional hearing outcomes. Data were collected from patients operated upon for otosclerosis by a single surgeon from 1990 to 1999. Pure-tone air (PTA), pure-tone bone (PTB), air-bone gap (ABG), air-conduction at 8 kHz (AC 8), bone-conduction at 4 kHz (BC4) and speech discrimination score (SDS) were compared between patients <45 and ≥45 years old, as well as correlated with overall age preoperatively, short term (4 months) and long term (>10 years), postoperatively. Forty-five patients were included with a mean follow-up of 12.6 years. Mean preoperative ABG and AC 8 values were significantly different between the two age groups (p = 0.002; p = 0.010, respectively). No values remained significantly different between the two age groups at the long-term follow-up. ABG values correlated with age preoperatively (p = 0.001), although no correlation was seen short- and long-term postoperatively (p = 0.980; p = 0.495, respectively). Mean PTA, PTB, and ABG values showed a significant improvement in both groups preoperatively to short-term postoperatively (p < 0.001). Although mean PTA values decreased significantly from short- to long-term follow-ups in both groups (p = 0.033; p = 0.020), the improvement from the preoperative state remained significant (p < 0.001). Regardless of age at the time of surgery, long-term hearing levels will evolve similarly in patients <45 and ≥45 years old. Furthermore, no difference will be seen in hearing measurements between the two age groups at ≥10 years postoperatively. Delaying a surgery would thus not affect overall long-term hearing outcomes.