Patient's Perspective and Change in Quality of Life After Stapes Surgery: A Multicenter Prospective Trial

Abstract

OBJECTIVE: This study evaluated outcomes of stapes surgery in otosclerosis patients by assessing audiometric results and health-related quality of life (HRQOL) using the Dutch Stapesplasty Outcome Test-25 (SPOT-25) questionnaire. Additionally, the role of SPOT-25 in preoperative decision-making and as a follow-up tool was explored. STUDY DESIGN: A prospective, multicenter cohort study. SETTING: One tertiary academic medical center and 3 secondary referral centers. METHODS: Data from 115 adult patients undergoing primary stapes surgery was analyzed. Audiometric outcomes were measured using pure-tone audiometry results and word recognition score (WRS). HRQOL was assessed using SPOT-25, Glasgow Health Status Questionnaire, and Glasgow Benefit Inventory. Pre- and postoperative outcomes were compared, and correlations between pure-tone audiometry results, WRS, and HRQOL were analyzed. Outcomes were compared between patients receiving 0.4 and 0.6 mm diameter pistons, and the impact of preoperative pure-tone audiometry results was analyzed. RESULTS: Significant postoperative improvements were observed in all audiometric measures (mean air conduction gain of 22 dB and air-bone gap (ABG) improvement of 18 dB). HRQOL also improved significantly (mean SPOT-25 score improved from 48 to 27). The 0.6 mm piston group had a significantly smaller postoperative ABG than the 0.4 mm group. Patients with a preoperative ABG ≤ 15 dB had a mean SPOT-25 gain of 19 (SD 22), whereas those with a preoperative ABG > 15 dB had a gain of 21 (SD 18). CONCLUSION: Stapes surgery significantly improves hearing and HRQOL. The SPOT-25 is a valuable tool for evaluating HRQOL and may assist in preoperative decision-making in patients with varying hearing impairments. LEVEL OF EVIDENCE: III.