Second Ear Surgery for Patients with Bilateral Otosclerosis: Recommended or not?

Materials and Methods: From 1996 to 2012, a cohort study was conducted on patients with otosclerosis after stapes surgery at a tertiary referral center in Taiwan. Only patients with bilateral otosclerosis were included. Hearing outcomes after the first and second ear surgeries were analysed. Logistic regression analysis was used to control confounding factors of hearing outcomes. We correlated the post-operative AC averages of firstand second-operated ears in patients undergoing bilateral surgeries. Results: Sixty-four operations were included (48 first and 16 second ear surgeries). There were no differences between first and second ear surgeries regarding the percentages of ears with post-operative ABG ≤10 dB and AC ≤30 dB (P > 0.05). For patients undergoing bilateral surgeries, the probability of symmetric hearing (interaural difference ≤10 dB) after second ear surgery (56%) was higher than that after the first ear surgery (19%, P = 0.028). A positive correlation existed between the postoperative AC averages of the first and second ear surgeries (Rho = 0.479, P = 0.030). Conclusions: Surgery on the contralateral ear is effective and can be recommended not only because second ear surgery showed comparable hearing outcomes with first one, but also because it provided binaurally symmetric hearing. In particular, for patients with normal or socially serviceable hearing after first ear surgery, the probability of hearing success tended to increase following second ear surgery.