KBB-Forum 2020 , Cilt 19, Sayı 4

PREDICTORS OF POSTOPERATIVE HEARING OUTCOMES AFTER ENDOSCOPIC STAPEDOTOMY SURGERY FOR OTOSCLEROSIS

Kamil Gökçe TULACI 1, MD; Erhan ARSLAN 1, MD; Hasan ÇANAKÇI 1, MD; Tugba TULACI 2, MD; Ceyhun CENGİZ 3, MD; Haşmet YAZICI 1, MD;
1Balıkesir Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz ve Baş Boyun Cerrahisi Anabilim Dalı, Balıkesir, Turkey
2Balıkesir Atatürk Şehir Hastanesi, Kulak Burun Boğaz ve Baş Boyun Cerrahisi Kliniği, Balıkesir, Turkey
3Bozok Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz ve Baş boyun Cerrahisi Anabilim Dalı, Yozgat, Turkey Aim: To investigate predictors of postoperative hearing outcomes in endoscopic stapedotomy.

Methods: Patients who underwent endoscopic stapedotomy for otosclerosis and met the inclusion criteria were included in this retrospective study.

Patients were divided into two groups according to postoperative functional success. Group 1 included patients whose postoperative air bone gap (ABG) was ≤10 dB, and Group 2 included patients whose postoperative ABG was >10 dB.

Logistic regression analysis were used to evaluate possible factors affecting postoperative hearing outcomes and receiver operating characteristics (ROC) analysis were used to identify the best cut-off threshold for predicting functional success.

Results: In both groups, statistically significant improvement was observed in mean air conduction (AC) threshold and mean ABG values after operation ( AC Group1: p<0.001, Group 2: p=0.023, ABG group1: p<0.001, group 2: p=0.002).

Group 1's mean preoperative ABG and preoperative AC thresholds were significantly lower than those of Group 2 (p<0.001 and p<0.001, respectively).

Preoperative AC thresholds and preoperative ABGs were found to be significant predictors of functional success. For AC: The area under the curve (AUC) = 0.913, 95% confidence interval (CI): 0.823-1.000, p < 0.001, and for ABG: AUC = 0.890, 95% CI: 0.753-1.000, p < 0.001.

The best cut-off thresholds in predicting the functional success of the operation were found to be 47.5 dB and 32.0 dB respectively for preoperative AC and preoperative ABG.

Conclusion: Lower preoperative ABGs and lower AC thresholds were found to be independent predictors of successful hearing outcomes for endoscopic stapedotomy. Keywords : Otosclerosis; Endoscopic stapes surgery; Stapedotomy; Predictive factors