Diagnosis and management of far-advanced otosclerosis.

Far-advanced otosclerosis, as defined by Sheehy, is suitable for surgical procedures provided certain criteria are met. These are: a history commensurate with otosclerosis, tuning fork tests indicative of some bone-conduction hearing, and good voice quality and articulation. It is not necessary to obtain any audiometric responses by air or bone conduction. Forty-one patients (59 ears) with far-advanced otosclerosis were designated as appropriate for stapes surgery on the basis of this specific diagnostic protocol. The diagnoses were confirmed at the time of surgery and 92% obtained some degree of postoperative improvement in hearing levels. It is evident that if the proper diagnostic criteria are used, the choice of stapes surgery for far-advanced otosclerosis is productive of satisfactory results.