Long-term hearing performance after stapedectomy

A RECENT survey of long-term results in stapedectomy detected unexpected high tone and speech discrimination losses after seven years (Smyth and Hassard, 1978). Statistical analysis of the data showed a strong correlation between the size of the oval window fenestra and cochlear dysfunction, both immediate and delayed. Although it was reassuring to find that small fenestra stapedectomy, using a 0 -3 mm Teflon piston, carried significantly less risk of complications, nevertheless, the conclusion that some degree of cochlear dysfunction followed all stapedectomies was inescapable. As a consequence it appeared possible that the combined effects of ageing and surgical trauma, and possibly cochlear otosclerosis, might eventually erode initial postoperative improvements in auditory status to such an extent that in due course even the most successful patients might eventually become seriously handicapped. this rate of and to predict the when, when threshold reaches 40 dB, poor discrimination by amplification operation, young patients requiring