Long-Term Hearing Outcomes Following Cochlear Implantation in Far Advanced Otosclerosis.

Objective: This study aims to evaluate the long-term auditory performance at 5 years in patients with far advanced otosclerosis (FAO) after cochlear implantation compared to controls.

Study design: A retrospective cohort study.

Setting: This study was conducted at a single tertiary medical center.

Methods: Patients with FAO were compared to a control group of postlingually deafened patients, selected from the same cochlear implant database. The following data were collected from medical records: age, sex, etiology, duration of hearing deprivation, prior stapes surgery, age at implantation, side of implantation, computed tomography scan findings, surgery details, postoperative complications, and hearing test results.

Results: A total of 41 patients with otosclerosis and 73 control cases were included in this study. The mean speech comprehension score at 5 years was 48.63% ± 24.66 in the otosclerosis group compared to 48.17% ± 23.08 in the control group (P = .76). Cochleostomy (P = .01), scala vestibuli insertion (P < .001), and postoperative dizziness (P < .01) were more common in the otosclerosis group. Facial nerve stimulation was observed in both groups: otosclerosis group 4 cases (9.8%) and control group 4 cases (5.48%) (P = .39). In the otosclerosis group, at 5 years, the average speech comprehension in patients with a previous stapedotomy was 39.3% ± 23.9 and 57.52% ± 22.45 in patients without a previous stapedotomy (P = .02).

Conclusion: Cochlear-implanted patients with otosclerosis achieve satisfactory long-term audiometric outcomes, although with higher surgical challenges and complication rates compared to other etiologies. Notably, we found that a history of stapedotomy can negatively impact long-term auditory outcomes after cochlear implantation.