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High-frequency hearing, tinnitus, and patient satisfaction with stapedotomy: A randomized prospective study.

Bagger-Sjöbäck D, Strömbäck K, Hultcrantz M, Papatziamos G, Smeds H, Danckwardt-Lillieström N, Tideholm B, Johansson A, Hellström S, Hakizimana P, Fridberger A - Sci Rep (2015)

Bottom Line: Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation.These findings have practical importance for patients and their surgeons.Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Karolinska University Hospital, Stockholm, Sweden.

ABSTRACT
Otosclerosis is a common disorder that leads to conductive hearing loss. Most patients with otosclerosis also have tinnitus, and surgical treatment is known to improve hearing as well as tinnitus. Some patients however experience worsening of tinnitus after the operation, but there are no known factors that allow surgeons to predict who will be at risk. In this prospective observational study on 133 patients undergoing stapedotomy, we show that postoperative air conduction thresholds at very high stimulus frequencies predict improvement of tinnitus, as assessed with proportional odds logistic regression models. Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation. These findings have practical importance for patients and their surgeons. Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.

No MeSH data available.


Related in: MedlinePlus

Patient characteristics before surgery.(a) Hearing thresholds for air-conducted sound. The size of each red dot corresponds to the number of patients, as determined from histograms with 5 dB bin widths. Horizontal black lines denote means, vertical lines the standard deviation. Numbers on the graph show the number of patients contributing to each average. High-frequency audiometry refers to the frequencies between 8 and 14 kHz. (b) Average thresholds for air-conducted sound across the frequencies 10 to 14 kHz as a function of patient age. (c) High-frequency air-conduction thresholds according to the sex of the patient. Red dots represent women, blue dots men. Dot sizes correspond to the number of patients at each threshold value (5-dB bins). Black lines denote means and standard deviations.
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f2: Patient characteristics before surgery.(a) Hearing thresholds for air-conducted sound. The size of each red dot corresponds to the number of patients, as determined from histograms with 5 dB bin widths. Horizontal black lines denote means, vertical lines the standard deviation. Numbers on the graph show the number of patients contributing to each average. High-frequency audiometry refers to the frequencies between 8 and 14 kHz. (b) Average thresholds for air-conducted sound across the frequencies 10 to 14 kHz as a function of patient age. (c) High-frequency air-conduction thresholds according to the sex of the patient. Red dots represent women, blue dots men. Dot sizes correspond to the number of patients at each threshold value (5-dB bins). Black lines denote means and standard deviations.

Mentions: Patients in the placebo group were 48.1 ± 11 years old (mean ± standard deviation (sd)), which was not significantly different from the N-Acetylcysteine group (49.1 ± 11 years; p = 0.63, t-test). The majority of patients were female (69% in the placebo group vs. 63% in the N-Acetylcysteine group; p = 0.7; χ2-test) and most had poor high-frequency air conduction thresholds prior to surgery (Fig. 2a; this figure also includes thresholds for air-conducted sound at the conventional set of frequencies, 0.25–8 kHz). With the exception of the Carhart notch frequencies, the average thresholds show the flat loss near 60 dB that is typical for advanced otosclerosis. Before surgery, there were no significant differences in air conduction thresholds between the N-Acetylcysteine and the placebo group (p = 0.54, linear mixed model). As reported previously25, N-Acetylcysteine had no effect on tinnitus and in the present study we found that it had no significant effect on high-frequency hearing thresholds after surgery (p = 0.59, linear mixed model, see reference 25 for additional details regarding the conventional set of frequencies and further characteristics of patients and surgical factors). We therefore performed further analysis without separating patients on the basis of the drug given.


High-frequency hearing, tinnitus, and patient satisfaction with stapedotomy: A randomized prospective study.

Bagger-Sjöbäck D, Strömbäck K, Hultcrantz M, Papatziamos G, Smeds H, Danckwardt-Lillieström N, Tideholm B, Johansson A, Hellström S, Hakizimana P, Fridberger A - Sci Rep (2015)

Patient characteristics before surgery.(a) Hearing thresholds for air-conducted sound. The size of each red dot corresponds to the number of patients, as determined from histograms with 5 dB bin widths. Horizontal black lines denote means, vertical lines the standard deviation. Numbers on the graph show the number of patients contributing to each average. High-frequency audiometry refers to the frequencies between 8 and 14 kHz. (b) Average thresholds for air-conducted sound across the frequencies 10 to 14 kHz as a function of patient age. (c) High-frequency air-conduction thresholds according to the sex of the patient. Red dots represent women, blue dots men. Dot sizes correspond to the number of patients at each threshold value (5-dB bins). Black lines denote means and standard deviations.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4544016&req=5

f2: Patient characteristics before surgery.(a) Hearing thresholds for air-conducted sound. The size of each red dot corresponds to the number of patients, as determined from histograms with 5 dB bin widths. Horizontal black lines denote means, vertical lines the standard deviation. Numbers on the graph show the number of patients contributing to each average. High-frequency audiometry refers to the frequencies between 8 and 14 kHz. (b) Average thresholds for air-conducted sound across the frequencies 10 to 14 kHz as a function of patient age. (c) High-frequency air-conduction thresholds according to the sex of the patient. Red dots represent women, blue dots men. Dot sizes correspond to the number of patients at each threshold value (5-dB bins). Black lines denote means and standard deviations.
Mentions: Patients in the placebo group were 48.1 ± 11 years old (mean ± standard deviation (sd)), which was not significantly different from the N-Acetylcysteine group (49.1 ± 11 years; p = 0.63, t-test). The majority of patients were female (69% in the placebo group vs. 63% in the N-Acetylcysteine group; p = 0.7; χ2-test) and most had poor high-frequency air conduction thresholds prior to surgery (Fig. 2a; this figure also includes thresholds for air-conducted sound at the conventional set of frequencies, 0.25–8 kHz). With the exception of the Carhart notch frequencies, the average thresholds show the flat loss near 60 dB that is typical for advanced otosclerosis. Before surgery, there were no significant differences in air conduction thresholds between the N-Acetylcysteine and the placebo group (p = 0.54, linear mixed model). As reported previously25, N-Acetylcysteine had no effect on tinnitus and in the present study we found that it had no significant effect on high-frequency hearing thresholds after surgery (p = 0.59, linear mixed model, see reference 25 for additional details regarding the conventional set of frequencies and further characteristics of patients and surgical factors). We therefore performed further analysis without separating patients on the basis of the drug given.

Bottom Line: Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation.These findings have practical importance for patients and their surgeons.Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology, Karolinska University Hospital, Stockholm, Sweden.

ABSTRACT
Otosclerosis is a common disorder that leads to conductive hearing loss. Most patients with otosclerosis also have tinnitus, and surgical treatment is known to improve hearing as well as tinnitus. Some patients however experience worsening of tinnitus after the operation, but there are no known factors that allow surgeons to predict who will be at risk. In this prospective observational study on 133 patients undergoing stapedotomy, we show that postoperative air conduction thresholds at very high stimulus frequencies predict improvement of tinnitus, as assessed with proportional odds logistic regression models. Young patients were significantly more likely to experience reduction of tinnitus and patients whose tinnitus became better were also more satisfied with the outcome of the operation. These findings have practical importance for patients and their surgeons. Young patients can be advised that surgery is likely to be beneficial for their tinnitus, but a less positive message should be conveyed to older patients.

No MeSH data available.


Related in: MedlinePlus