Efficacy of evaluation of audiometric results after stapes surgery in otosclerosis. I. The effects of using different audiologic parameters and criteria on success rates

The Committee on Hearing and Equilibrium of the American Academy of Otolary ngology-Head and Neck Surgery proposed guidelines to provide more uniformit y in reporting hearing results after middle ear surgery, One of the proposa ls was to include the hearing thresholds at 0.5, 1,2, and 3 kHz in a 4-freq uency pure-tone average (PTA) and to use postoperative bone-conduction (BC) levels rather than preoperative BC levels in describing postoperative air- bone gaps (ABGs), The hearing results of 451 stapes operations were evaluat ed to analyze to what extent the choice of different audiologic criteria af fects success rates. It appeared that choice of PTA significantly affects p ostoperative gain in air-conduction thresholds and ABG levels. If one takes the improvements in speech-reception thresholds as the gold standard, the gain in air-conduction correlates best with a gain in speech-reception thre shold if a higher frequency, such as 3 or 4 kHz, is included in a 4-frequen cy PTA. Also, choice of preoperative or postoperative BC in computing posto perative ABGs had a significant effect on the mean postoperative ABG levels , showing more favorable results with the use of preoperative BC thresholds .