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OBJECTIVE: To evaluate the psychometric properties of the Swedish version of the Glasgow Benefit Inventory (GBI). METHODS: A prospective multicenter cohort study was conducted. A total of 123 otosclerosis subjects were included in the study. The subjects were divided in three groups based on the following interventions: (a) stapedotomy without any prior hearing-aid rehabilitation (n = 60); (b) hearing-aid rehabilitation without any prior stapedotomy (n = 33); and (c) stapedotomy with prior hearing-aid rehabilitation (n = 30). Pre- and post-operative pure tone audiometry were measured. The Swedish version of the GBI was completed by the subjects 6 months after the intervention. Test-retest reliability and internal consistency, factor analysis, construct validity, and criterion validity, was assessed. RESULTS: The Swedish version of the GBI was well accepted by the subjects. It showed good psychometric properties with an overall high reliability. Factor analysis resulted in a 5-factor solution explaining 66.6% of the variance where factors 1 and 2 represented the general health domain. CONCLUSIONS: Overall, the Swedish version of the GBI showed good psychometric properties. Based on the factor analyses, there is the possibility that the general health domain should be divided in two separate domains: general health and psychosocial health. LEVEL OF EVIDENCE: 2c.

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OBJECTIVES: The aims of the study were to assess health-related quality of life and hearing-related disability in subjects with otosclerosis 30 years after surgery. DESIGN: An observational study was performed. Medical records were reviewed, a clinical examination as well as audiometric assessments were performed. Generic health-related quality of life was assessed by the SF-36v2 and hearing disability by a shortened version of SSQ (speech spatial and qualities of hearing scale). STUDY SAMPLE: Sixty-five individuals, who had undergone stapedectomy in 1977-79 at a tertiary referral center. RESULTS: Generic health-related quality of life according to SF-36 subscale scores was comparable to that of an age- and sex-matched reference population. The SF-36 mental component summary score (MCS) was, however, significantly better than that of the reference population. The mental and physical summary component scores correlated significantly to hearing disability measured by the SSQ but not to hearing impairment. Hearing disability was displayed in all SSQ sub-scores, especially in more complex listening situations and in the localization of sounds. CONCLUSIONS: This study shows that individuals with otosclerosis, 30 years after surgery, have a good generic health-related quality of life, despite moderate to severe hearing loss and significant hearing disabilities.

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OBJECTIVES: The aims of the study were to assess hearing-aid uptake in patients with otosclerosis 28-30 years after stapedectomy and to evaluate hearing-aid benefit to users. DESIGN: A retrospective study was performed; it included a review of medical records and follow-up 28-30 years after surgery, including audiometry, clinical examination, structured interview, and a validated questionnaire, IOI-HA. STUDY SAMPLE: Sixty-five patients, who had undergone stapedectomy at a tertiary referral center in 1977-79. RESULTS: In 95% of the subjects there was a theoretical need for hearing-aid amplification at follow-up; 46% of the subjects had no hearing aids, while 26% had unilateral and 28% bilateral hearing aids. Hearing sensitivity in the best ear predicted hearing-aid uptake. Of the subjects with a hearing aid, 94% were everyday users and 54% were full-time users (> 8 hours/day). The subjects reported a high level of satisfaction (mean 4.5) and benefit (mean 4.2), but also residual activity limitations (mean 3.1). CONCLUSIONS: The study shows that there is an unmet need for long-term hearing rehabilitation among patients previously undergoing surgery for otosclerosis. The patients who were using hearing aids were generally very satisfied with their hearing aids, but they still reported residual activity limitations.

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OBJECTIVE: To assess the use of cone beam computed tomography (CBCT) compared with multi-slice computed tomography (MSCT) in otosclerosis, with special emphasis on middle- and inner-ear anatomy. STUDY DESIGN: Prospective study. PATIENTS: Twenty patients who underwent a stapedectomy 30 years ago were selected on the basis of bone conduction threshold values. Their mean age was 65 years (range, 48-76 yr). INTERVENTION: All patients underwent CBCT and MSCT with a slice thickness of 0.5 to 0.6 mm. MAIN OUTCOME MEASURES: Sixteen middle- and inner-ear anatomic structures and stapedial prostheses were analyzed by visual grading analysis. To assess critical reproduction and thereby the clinical applicability of CBCT, a dichotomization was made. Assessment of otosclerotic foci was performed using a grading system dividing the lesions in; (1) sole fenestral lesions, (2) retrofenestral lesions with or without fenestral lesions and (3) severe retrofenestral lesions. RESULTS: The 16 anatomic structures were clearly reproduced by both imaging techniques. However, there was an interobserver variation in judging the superiority of 1 method in favor of the other. Otosclerotic lesions were diagnosed in 80/95% using MSCT and 50/85% using CBCT (evaluators 1 and 2, respectively). Retrofenestral lesions were diagnosed in 5 of 10 of ears with severe-to-profound hearing loss, whereas no retrofenestral lesions were diagnosed in the 10 ears with mild-to-moderate hearing loss. The stapedial prostheses were adequately or very well reproduced by both methods. CONCLUSION: CBCT is a new imaging technique with a considerably lower radiation dose than conventional MSCT. Our study indicates that CBCT is suitable and, in many ways, equivalent to MSCT, for temporal bone imaging in otosclerosis.

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OBJECTIVES: The aims of this study were to evaluate the hearing outcomes 28 to 30 years after stapedectomy in patients with surgically confirmed otosclerosis, and to evaluate inner ear involvement. METHODS: A retrospective clinical study was performed. Sixty-five consecutive patients who underwent stapedectomy at a tertiary referral center between 1977 and 1979 were included in the study. Medical records, including preoperative and postoperative audiograms, were reviewed, and a long-term follow-up clinical examination and pure tone audiometry were performed. The hearing outcome was compared with that of a reference population (ISO 7029) in terms of age and gender. RESULTS: Thirty years after stapedectomy, 66% of the patients' ears studied showed a moderate to profound hearing loss. The deterioration was mainly caused by a sensory hearing loss. The hearing loss was significantly greater than that in the reference population for both air and bone conduction thresholds at the early and late stages of the disease. A large majority of the patients (88%) had bilateral otosclerosis. CONCLUSIONS: Patients with otosclerosis have a sensorineural hearing loss that cannot be explained by age. Otosclerosis should be regarded as a middle and inner ear disease. Almost all patients with otosclerosis are in need of ongoing audiological rehabilitation and hearing aids.

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