Auditory and Vestibular Recovery in Otosclerosis Surgery: Clinical Efficacy and Predictive Modeling of Intraoperative Corticosteroid Use

Aliyeva A., Muradova A., Hashimli R.

Otolaryngology - Head and Neck Surgery (United States), cilt.174, sa.4, ss.1080-1090, 2026 (SCI-Expanded, Scopus) identifier identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 174 Sayı: 4
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1002/ohn.70157
  • Dergi Adı: Otolaryngology - Head and Neck Surgery (United States)
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.1080-1090
  • Anahtar Kelimeler: corticosteroid, dizziness, hearing loss, machine learning, otosclerosis, predictive modeling, stapedotomy, tinnitus
  • Ankara Üniversitesi Adresli: Evet

Özet

Objective: To evaluate the effect of intraoperative local corticosteroid application on hearing, tinnitus, and dizziness outcomes after stapes surgery for otosclerosis, and to assess predictive modeling for treatment response. Study Design: Retrospective multicenter cohort study. Setting: Three tertiary referral hospitals. Methods: Two hundred primary stapedotomy patients were analyzed: Group 1 (n = 100) received topical triamcinolone acetonide (40 mg/mL) applied to the oval window/footplate; Group 2 (n = 100) underwent standard surgery without steroids. Preoperative and 3-month postoperative evaluations included pure tone thresholds, air-bone gap (ABG), speech discrimination score (SDS), Tinnitus Handicap Inventory (THI), and Dizziness Handicap Inventory (DHI). Machine learning algorithms identified predictors of a favorable response. Results: The steroid group achieved significantly greater hearing gains at all frequencies, most pronounced at 8000 Hz (28.13 ± 6.7 vs 19.09 ± 5.4 dB; P <.001), higher SDS (+6.37% vs −1.52%; P =.006), and superior ABG closure (P =.004). THI and DHI scores improved significantly (P <.001). Machine learning models achieved an AUC of 0.92 for outcome prediction. Conclusion: Intraoperative corticosteroids significantly enhance auditory and vestibular recovery in stapes surgery and, combined with predictive modeling, may support personalized patient care.