FAR-ADVANCED OTOSCLEROSIS

Far-advanced otosclerosis (FAO) is an uncommon diagnosis. Hearing leve ls in patients with FAO may range from profound loss, by air conductio n and fragmentary bone conduction thresholds, to no measurable air or bone conduction thresholds. Thus, FAO may be difficult to distinguish from a sensorineural hearing loss. This report presents the results of surgery in 73 ears with FAO, 77 percent of which had improvement in a ir conduction thresholds of greater than 20 dB. Discrimination was imp roved by more than 15 percent in 54 percent of cases, and 75 percent r ealized improvement in use of a hearing aid. There was no evidence tha t success was related to preoperative hearing. The surgical results of a subgroup of 14 patients having bilateral FAO were also analyzed. Fo r all 14, similar surgical outcomes were achieved in both the initial and the contralateral ear, with six successes bilaterally and eight fa ilures bilaterally. Although far advanced otosclerosis is uncommon and difficult to diagnose, surgery is worthwhile.