Xin yixue (Mar 2024)

Clinical efficacy and influencing factors of stapedotomy combined with artificial stapes implantation for tinnitus in patients with otosclerosis

  • Tian Jiawang, Li Yongqi

DOI
https://doi.org/10.3969/j.issn.0253-9802.2024.03.015
Journal volume & issue
Vol. 55, no. 3
pp. 233 – 237

Abstract

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Objective To analyze the changes in tinnitus after stapedotomy combined with artificial stapes implantation， and further explore the factors influencing the efficacy of postoperative tinnitus in patients with otosclerosis. Methods A total of 54 patients （65 ears） with otosclerosis complicated with tinnitus symptoms who underwent stapedotomy combined with artificial stapes implantation were enrolled. The hearing test results of all patients before surgery， 1 and 6 months after surgery were recorded. The scores of Tinnitus Handicap Inventory （THI） and Clinical Global Impression Scale （CGI-S） before surgery， 1 and 6 months after surgery were compared. Results Before surgery， low-frequency （<1 kHz） tinnitus was observed in 31 ears （47.7%）， medium-frequency （1-4 kHz） tinnitus in 14 ears （21.5%）， and high-frequency （≥4 kHz） tinnitus in 20 ears （30.8%）. At 1 month after surgery， tinnitus symptom was alleviated in 48 ears （73.8%） （complete healing and mitigation of tinnitus）， no changes in 16 ears （24.6%）， and tinnitus symptom was aggravated in 1 ear （1.5%）. At 6 months after surgery， tinnitus symptom was eased in 50 ears （76.9%）， no changes in 13 ears （20.0%）， and tinnitus symptom was aggravated in 1 ear （1.5%）. Patients with low- and medium-frequency tinnitus obtained more significant improvement in tinnitus compared with their counterparts with high-frequency tinnitus （P < 0.001 and P = 0.013）. At postoperative 1 month， the changes in subjective tinnitus， such as the average air conduction and bone conduction thresholds significantly differed from those before surgery （all P < 0.001）， whereas there was no statistical significance in air-bone gap （P > 0.05）. Conclusions Stapedotomy combined with artificial stapes implantation can not only restore the hearing of patients with otosclerosis， but also mitigate the tinnitus symptoms in most patients. Patients with low- and medium-frequency tinnitus before surgery can obtain more significant improvements in tinnitus after surgery than those with high-frequency tinnitus.

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