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<p>Otosclerosis is a common cause of progressive conductive hearing loss due to stapes fixation. While audiometric measures remain the primary benchmark for surgical success, patient-centered outcomes such as quality of life (QOL) are increasingly recognized for their clinical relevance. To evaluate the postoperative quality of life in patients undergoing otosclerosis surgery and identify key clinical, radiological, and surgical predictors of subjective improvement. This cross-sectional study included 74 patients who underwent unilateral stapedotomy at the Mohammed VI University Hospital in Marrakech between April 2015 and April 2025. Hearing-specific QOL was assessed using the approved Arabic translation of the Speech, Spatial, and Qualities of Hearing Scale (SSQ12), while general QOL was evaluated with the validated Arabic version of the Personal Wellbeing Index (PWI). Clinical variables included age, sex, years since surgery, otosclerosis stage (Veillon classification), otosclerosis type (uni or bilateral), hearing aid history, pre- and postoperative audiometric thresholds, air-bone gap (ABG) before and after the surgery, surgeon and piston size. Pearson correlation analysis and feature ranking were used to explore relationships between clinical parameters and QOL outcomes. Air-bone gap (ABG) closure in the operated ear demonstrated a strong positive correlation with the SSQ12 score (<i>r</i> = 0.80) and a moderate correlation with PWI score (<i>r</i> = 0.59). Greater preoperative ABG and baseline hearing loss were also associated with higher subjective benefit, indicating that patients with more severe initial impairment perceived greater improvement. Age, otosclerosis type, hearing aid history, years since surgery, surgeon identity, and radiological stage (Veillon classification) showed minimal influence on outcomes, though Veillon stage displayed a modest correlation with PWI gain (<i>r</i> = 0.23). Piston diameter (0.4&#xa0;mm vs. 0.6&#xa0;mm) had no significant impact on postoperative quality of life. A low-to-moderate correlation (<i>r</i> = 0.32) was observed between ABG gains in the operated and non-operated ears; linear regression showed that each 1 dB improvement in the operated ear was associated with an average 0.12 dB gain in the contralateral ear. Quality of life after otosclerosis surgery is closely related to audiometric improvement, particularly the reduction in air-bone gap. Integrating validated subjective QOL metrics with clinical data provides a more comprehensive evaluation of surgical outcomes, enhancing patient counseling and postoperative expectations.</p>

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Assessing the Impact of Clinical and Surgical Factors on Quality of Life After Otosclerosis Surgery Using Digital Modelization

  • 期刊论文

  • 发表日期：

    2026年7月6日

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  • Mohamed Chehbouni,
  • Mohammed Rami,
  • Omar Oulghoul,
  • Ismail El Boussouni,
  • Youssef Lakhdar,
  • Youssef Rochdi,
  • Abdelaziz Raji

摘要

Otosclerosis is a common cause of progressive conductive hearing loss due to stapes fixation. While audiometric measures remain the primary benchmark for surgical success, patient-centered outcomes such as quality of life (QOL) are increasingly recognized for their clinical relevance. To evaluate the postoperative quality of life in patients undergoing otosclerosis surgery and identify key clinical, radiological, and surgical predictors of subjective improvement. This cross-sectional study included 74 patients who underwent unilateral stapedotomy at the Mohammed VI University Hospital in Marrakech between April 2015 and April 2025. Hearing-specific QOL was assessed using the approved Arabic translation of the Speech, Spatial, and Qualities of Hearing Scale (SSQ12), while general QOL was evaluated with the validated Arabic version of the Personal Wellbeing Index (PWI). Clinical variables included age, sex, years since surgery, otosclerosis stage (Veillon classification), otosclerosis type (uni or bilateral), hearing aid history, pre- and postoperative audiometric thresholds, air-bone gap (ABG) before and after the surgery, surgeon and piston size. Pearson correlation analysis and feature ranking were used to explore relationships between clinical parameters and QOL outcomes. Air-bone gap (ABG) closure in the operated ear demonstrated a strong positive correlation with the SSQ12 score (r = 0.80) and a moderate correlation with PWI score (r = 0.59). Greater preoperative ABG and baseline hearing loss were also associated with higher subjective benefit, indicating that patients with more severe initial impairment perceived greater improvement. Age, otosclerosis type, hearing aid history, years since surgery, surgeon identity, and radiological stage (Veillon classification) showed minimal influence on outcomes, though Veillon stage displayed a modest correlation with PWI gain (r = 0.23). Piston diameter (0.4 mm vs. 0.6 mm) had no significant impact on postoperative quality of life. A low-to-moderate correlation (r = 0.32) was observed between ABG gains in the operated and non-operated ears; linear regression showed that each 1 dB improvement in the operated ear was associated with an average 0.12 dB gain in the contralateral ear. Quality of life after otosclerosis surgery is closely related to audiometric improvement, particularly the reduction in air-bone gap. Integrating validated subjective QOL metrics with clinical data provides a more comprehensive evaluation of surgical outcomes, enhancing patient counseling and postoperative expectations.