title: Factors affecting postoperative outcome in otosclerosis patients: Predictive role of audiological and clinical features.
abstract: OBJECTIVE
  Factors affecting postoperative hearing results of patients with otosclerosis were analyzed.
  
  
  METHODS
  Included were 191 patients with otosclerosis in whom 234 primary stapes surgeries were performed from August 1991 to December 2011 by one surgeon in three tertiary hospitals. Evaluation of factors affecting postoperative hearing thresholds at individual frequencies were performed by logistic regression analysis.
  
  
  RESULTS
  Closure of the air-bone gap (ABG) after surgery was good at 2kHz, but poor at 4kHz and frequencies under 1kHz. In addition, improvement at 8kHz was worse than that at any other frequency. Multivariate logistic regression analysis by the stepwise method showed that under the mean preoperative ABG (odds ratio [OR]=2.42), unilaterality (OR=2.53) and male sex (OR=2.65) were significantly better prognostic factors at 250Hz. At 500Hz, under mean preoperative ABG (OR=2.56) was the significantly better factor. No significant factors were found at 1kHz. Cochlear otosclerosis (OR=3.57) was a significantly worse prognostic factor at 2kHz. Under mean preoperative ABG (OR=2.82) and younger age (OR=1.03) were significantly better prognostic factors at 4kHz. At 8kHz, worse preoperative air conduction threshold (OR=1.96) was a significantly better prognostic factor.
  
  
  CONCLUSIONS
  Preoperative ABG, preoperative air conduction threshold, cochlear otosclerosis, male sex, laterality and age were significant prognostic factors for postoperative hearing outcome in otosclerosis patients. Especially, preoperative ABG was a significant prognostic factor at multiple frequencies. We suppose that patients with larger preoperative ABG have some other otosclerotic lesions outside the oval window niche.
authors: Department of Otorhinolaryngology, Aichi Medical University School of Medicine, Aichi, Japan.
authors: Mayuko
authors: M
authors: Kishimoto
authors: Department of Otorhinolaryngology, Aichi Medical University School of Medicine, Aichi, Japan. Electronic address: uehiromi@aichi-med-u.ac.jp.
authors: Hiromi
authors: H
authors: Ueda
authors: Department of Otorhinolaryngology, Aichi Medical University School of Medicine, Aichi, Japan.
authors: Yasue
authors: Y
authors: Uchida
authors: Department of Otorhinolaryngology, Nagoya University School of Medicine, Nagoya, Japan.
authors: Michihiko
authors: M
authors: Sone
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001309:Auditory Threshold; D001844:Bone Conduction; D002648:Child; D005260:Female; D034381:Hearing Loss / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006320:Hearing Tests; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors; D013200:Stapes Mobilization; D013201:Stapes Surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: Factor; Multivariate regression analysis; Otosclerosis; Postoperative air-bone gap