title: Very far-advanced otosclerosis: stapedotomy or cochlear implantation.
abstract: CONCLUSIONS
  Every patient with severe or profound hearing loss must have a temporal bone high-resolution computed tomography (CT) scan. Stapedotomy is a simple, safe and low-cost procedure compared with cochlear implantation and can provide very good results. This can justify our decision to propose stapedotomy at the initial treatment in patients with very far-advanced otosclerosis. In cases of hearing failure after stapes surgery, cochlear implantation is an option.
  
  
  OBJECTIVE
  This study aimed to find the best first intention treatment of very far-advanced otosclerosis.
  
  
  METHODS
  This was a retrospective study and included 14 patients with non-measurable preoperative bone and air conduction thresholds and otosclerosis on temporal bone high-resolution CT scan. Stapes surgery followed by a well fitted hearing aid was the initial treatment in 11 patients and cochlear implantation in 7 patients, including 4 patients who had poor results after stapedotomy. Objective and subjective audiometric results were studied and compared between stapedotomy and cochlear implantation groups.
  
  
  RESULTS
  Objective and subjective results were statistically better in the cochlear implant group than in the stapedotomy group. However, four patients in the stapedotomy group had comparable results to the patients with cochlear implants.
authors.affiliation: Department of Otology-Neurotology and Skull Base Surgery, Purpan Hospital, Toulouse, CHU Toulouse, France. calmels.mn@chu-toulouse.fr
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Calmels
authors.forename: Corintho
authors.initials: C
authors.lastname: Viana
authors.forename: Georges
authors.initials: G
authors.lastname: Wanna
authors.forename: Mathieu
authors.initials: M
authors.lastname: Marx
authors.forename: Chris
authors.initials: C
authors.lastname: James
authors.forename: Olivier
authors.initials: O
authors.lastname: Deguine
authors.forename: Bernard
authors.initials: B
authors.lastname: Fraysse
mesh_terms: D000368:Aged; D001309:Auditory Threshold / Q000502:physiology; D001844:Bone Conduction / Q000502:physiology; D019929:Cochlear Implantation / Q000295:instrumentation; D005260:Female; D006310:Hearing Aids; D006319:Hearing Loss, Sensorineural / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D011474:Prosthesis Design; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013067:Speech Perception / Q000502:physiology; D013201:Stapes Surgery; D014057:Tomography, X-Ray Computed