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  • Title: High-frequency sensorineural hearing loss after stapedectomy.
    Author: Bauchet St Martin M, Rubinstein EN, Hirsch BE.
    Journal: Otol Neurotol; 2008 Jun; 29(4):447-52. PubMed ID: 18520581.
    Abstract:
    OBJECTIVE: To describe the pattern and duration of high frequency sensorineural hearing loss after stapedectomy. STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. PATIENTS: All patients who underwent stapedectomy by the senior author during the period between January 1, 1998, and October 1, 2005, with preoperative, 4- to 6-week postoperative, and at least 9-month postoperative audiograms were included. Fifty-three patients met the inclusion criteria, with surgeries performed on 61 ears. INTERVENTION(S): Stapedectomy was performed using a CO2 laser. MAIN OUTCOME MEASURE(S): Mean preoperative and postoperative pure-tone bone thresholds, mean preoperative and postoperative pure-tone air thresholds, and hearing outcomes for 4,000 Hz bone conduction (BC) and 8,000 Hz air conduction (AC) based on the patient's age and interval after the operative procedure. RESULTS: : Mean BC thresholds at 4,000 Hz BC worsened by 6 dB at 4 to 6 weeks and improved by 3 dB by 9 months. There was an 8-dB average loss at 8,000 Hz AC at 4 to 6 weeks with a gain of 4 dB by 9 months. Patients older than 40 years were 4 times more likely to experience early loss at 4,000 Hz BC when preoperative thresholds were held constant. The late outcome for hearing loss was dependent more on the preoperative threshold than was the age of the patient. At 8,000 Hz AC, the preoperative hearing threshold was a predictor of early and late hearing loss at 8,000 Hz. CONCLUSION: High-frequency sensorineural hearing loss is initially seen after stapes surgery, and improvement does occur over time. When preoperative hearing threshold is held constant, patients older than 40 years are more likely to experience short-term hearing loss at high frequencies than patients younger than 40 years. Age was not a predictor of postoperative high-frequency hearing loss in the long term.
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