{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T09:49:42Z","timestamp":1791798582243,"version":"4.3.4"},"reference-count":77,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To quantify the cumulative number of images needed to scan (NNS) with preoperative high\u2010resolution temporal bone computed tomography (HR\u2010TBCT) to yield a change in management in patients undergoing primary stapes surgery for otosclerosis\u2010related hearing loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary academic referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical records of all patients referred for primary stapes surgery between 2010 and 2025 were reviewed. All patients suspected of otosclerosis routinely underwent preoperative HR\u2010TBCT scan, and their CT findings were compared to the intraoperative findings of those who underwent surgery. All findings that altered informed consent, surgical candidacy, or surgical approach were recorded. The cumulative and temporal bone\u2010specific condition NNS were calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 892 patients were identified (male\u2010to\u2010female ratio 305:587). HR\u2010TBCT revealed temporal bone pathology resulting in management change in 14% (1\n                      <jats:sup>24<\/jats:sup>\n                      ears). Prevalence of temporal bone conditions that alter management of stapes surgery included third window lesions (5.8%), lateral ossicular chain fixation (4.1%), overhanging facial nerve (1.3%), obliterative otosclerosis (1.0%), far\u2010advanced otosclerosis (1.0%), and persistent stapedial artery (0.6%). The cumulative NNS for at least one management change, confirmed intraoperatively, was 38 (95% confidence interval 77\u201022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Routine preoperative HR\u2010TBCT identifies clinically significant temporal bone pathology that alters management in approximately 14% of stapes surgery candidates. The NNS for intraoperatively confirmed findings was 38. HR\u2010TBCT facilitates more accurate patient selection, improves informed consent, and reduces intraoperative complications. Incorporating HR\u2010TBCT into the preoperative assessment enables comprehensive presurgical counseling and planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70320","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T13:04:21Z","timestamp":1782219861000},"page":"906-914","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Scan for Success? 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