Stapedotomy for fenestral otosclerosis: long term audiovestibular outcomes and complications

Objectives: Otosclerosis is a progressive disease of the otic capsule characterised by disordered bone remodelling with abnormal resorption and neoformation of the temporal bone. Fenestral (or stapedial) otosclerosis is the most frequent form, when the focus of demineralisation involves the stapes footplate and the oval window. Stapedotomy and stapedectomy are indisputably the two main stapes surgery techniques for otosclerosis. The aims of this article are to evaluate the outcome of stapedotomy in terms of long-term audiological results and possible onset of late audiovestibular complications. Methods: This retrospective study included 63 patients who underwent primary stapedotomy for treatment of conductive hearing loss due to otosclerosis with more than 15 years postoperative follow-up. Results: We compared the preoperative results with the long-term stapedotomy results and observed an improvement of the pure tone average (PTA) for air conduction (AC) of 10.6 +/- 7.6 dB and an average air/bone gap (ABG) improvement of 22.6 +/- 5.7 dB. A surgical revision was necessary in two cases (3%). Complications included tinnitus in 5 cases and a temporary hypogeusia in two patients (3%); in the immediate postoperative period, 6 patients (10.2%) complained of vertigo. Conclusions: Our results provide further evidence of the validity of stapedotomy as the reference technique for the surgical treatment of fenestral otosclerosis.