title: Indication for surgery in otosclerotic patients with unilateral hearing loss.
abstract: OBJECTIVE
  The aim of this study is to evaluate postoperative spatial speech discrimination in noise in a group of otosclerotic patients with unilateral hearing loss in a 6-month follow-up. Moreover, an additional objective is to verify if our routine criteria (air-bone gap >30 dB at 250-2,000 Hz) for surgical indication in such patients can be acceptable.
  
  
  METHODS
  Prospective evaluation in 20 patients divided into 2 groups: unilateral otosclerosis and bilateral otosclerosis already successfully operated on 1 side and planned for stapedotomy on the contralateral ear.
  
  
  METHODS
  Tertiary referral center, University clinic.
  
  
  METHODS
  Otosclerotic patients with unilateral hearing loss.
  
  
  METHODS
  Evaluation of functional outcome.
  
  
  METHODS
  Spatial test based on speech discrimination in noise.
  
  
  RESULTS
  All patients reach postoperative air-bone gap closure within 10 dB. Average postoperative gain in discrimination under noise was 11.5% for unilateral otosclerosis group and 19.3% for the second ear group.
  
  
  CONCLUSIONS
  Free-field discrimination in noise closely reflects the usual listening conditions in everyday life. Improvement in postoperative free-field discrimination in noise can justify our routine criteria for surgical indication in the patients with unilateral otosclerosis and with bilateral otosclerosis already operated on 1 side. The surgical choice for each patient, apart from audiologic evaluation, is linked to a truly informed consent regarding possible advantages and risks mainly based on an analysis of the real auditory needs of the patient and individual results of the surgeon.
authors.affiliation: Department of Neurology and Otolaryngology, Sapienza University of Rome, Rome, Italy. edeseta@yahoo.it
authors.forename: Elio
authors.initials: E
authors.lastname: De Seta
authors.forename: Gianluca
authors.initials: G
authors.lastname: Rispoli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Balsamo
authors.forename: Edoardo
authors.initials: E
authors.lastname: Covelli
authors.forename: Daniele
authors.initials: D
authors.lastname: De Seta
authors.forename: Roberto
authors.initials: R
authors.lastname: Filipo
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D046088:Hearing Loss, Unilateral / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D010040:Otosclerosis / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D013063:Speech Discrimination Tests; D013067:Speech Perception / Q000502:physiology; D013201:Stapes Surgery; D016896:Treatment Outcome