Introduction: Surgical treatment of otosclerosis has been a commonly accepted method of treatment for many years. The improvement of hearing after surgery is sometimes even spectacular, and good results are obtained in many centres in over 90% of the entire operated population. However, in the years following the procedure, some patients develop permanent or progressive conductive hearing loss. The aim of the study is to present a group of patients with conductive hearing loss that appeared after the first otosclerosis surgery and to analyse the causes of its occurrence.
Material and Methods: Retrospective analysis was performed on patients who were first operated on in the years 2000-2009. Their medical records were analysed by the end of 2019, which made it possible to obtain results on at least 10 years of postoperative follow-up. The group consisted of 1118 patients, aged 14-82, including 802 women and 316 men.
Results: Reoperations due to conductive hearing loss were performed on 93 patients, who accounted for 8.3% of the originally operated patients. They were much more often performed on patients after stapedectomies (19.7%) than on patients after stapedotomy (5.5%). Intraoperatively, prosthesis displacement was found to be the most frequent observation (44.1%) and was often associated with erosion or necrosis of the long process of incus (28%). Less frequent reasons of hearing loss were: adhesions around the prosthesis (10.8%), too small hole in the stapes footplate (8.6%), too short prosthesis (8.6%), progression of otosclerosis (7.5%), too long prosthesis (6.4%), presence of a granuloma around the prosthesis (5.4 %), and displacement of incus (4.3%).
Conclusions: Surgical treatment in otosclerosis is a widely accepted and good method. It allows improvement in hearing in the vast majority of patients treated in this way. Unfortunately, over the years, some patients develop conductive hearing loss again. Reoperation gives a chance to find the cause and improve hearing in most of these cases.
Cone-Beam CT compared to Multi-slice CT for the diagnostic analysis of conductive hearing loss, a pilot study
