Evaluating the benefits and outcomes of second ear surgeries in bilateral stapedectomies: a comprehensive analysis

Background: Objectives of the study were to evaluate the anatomical abnormalities and benefits of second ear surgery in patients with bilateral otosclerosis undergoing stapedectomy. Methods: A descriptive retrospective study was done in 43 patients undergoing bilateral stapedotomy in a tertiary care centre. Anatomical abnormalties presenting intraoperative were recorded in both operated ears. Hearing outcomes after the first and second ear surgeries were recorded. Chi square and paired t test was used to find the association between categorical and continuous variables between both groups. We correlated the post-operative air conduction (AC) averages, air bone gap (ABG) gain, AC gain between first and second operated ears. Results: Obliterative FP was the most common abnormality seen 7%, followed by facial nerve anamolies 5%. Bilateral variations were seen in 66% and 60% respectively. 66% required bilateral drill outs. After 1st ear and 2nd ear surgery 81% and 76% gained normal hearing. Average postop AC threshold was significantly higher after first ear surgery (p<0.001). ABG and AC gain had no significant difference in both ears. Binaural symmetrical hearing with inter aural difference AB<10 dB was achieved in 90% of patients. Conclusions: It is worthwhile to recommend the patients to undergo contralateral ear surgery if the first ear had achieved normal or socially acceptable hearing, as the chances of achieving a comparable hearing outcome as that of 1st ear is high. Following 2nd ear surgery an effective binaural symmetric hearing can be achieved.