{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T07:03:30Z","timestamp":1785135810288,"version":"3.55.0"},"reference-count":18,"publisher":"Tsinghua University Press","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To analyze the characteristics of bone conduction (BC) threshold changes after stapedotomy in patients with otosclerosis, and to explore the clinical significance and implications for the evaluation of surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>It is a retrospective, single-center study. A total of 97 ears from patients with otosclerosis who underwent endoscopic stapedotomy (footplate fenestration with titanium piston implantation) between November 2015 and February 2025 were included. Pure tone audiometry (PTA) was performed preoperatively, and at 1 month and 6 months postoperatively. Air conduction (AC) thresholds were tested at 125\u20138000 Hz, and bone conduction (BC) thresholds at 250\u20134000 Hz. Pre- and postoperative changes in BC thresholds, AC thresholds, and air-bone gap (ABG) were documented, and the results were compared with findings from other studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The average postoperative BC threshold across 250\u20134000 Hz showed significant improvement, with a mean gain of 7.5 dB (Z = -6.343, p&lt;0.001). At individual frequencies, improvements were significant at 250, 500,1000, 2000 Hz, with the most notable gain at 250 Hz (10 dB), followed by 500 Hz, 1000 Hz, and 2000 Hz (5 dB gain each) (all p&lt;0.001). No statistically significant improvement of BC threshold was observed at 4000 Hz (Z = -0.368, p = 0.713). AC thresholds also showed significant improvements across all tested frequencies (125\u20134000 Hz) (all p&lt;0.001), with a mean gain of 19 dB; the greatest improvement was observed at 1000 Hz (30 dB). Although the average ABG narrowed by 13 dB, the degree of closure underestimates the actual hearing improvement, as it fails to account for concurrent BC enhancement. Compared with those of other studies, the study cohort demonstrated more pronounced BC improvements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Stapedotomy not only effectively restores AC hearing but also significantly improves BC thresholds. This improvement in BC thresholds may be attributed to the restoration of bone conduction mechanisms following stapedotomy. Traditional evaluation methods for surgical outcomes that rely solely on ABG closure tend to underestimate overall surgical efficacy. For clinical implementation, we suggest a multidimensional framework can be applied by simultaneously evaluating postoperative air conduction gain, bone conduction gain, and air\u2011bone gap closure at each frequency, rather than relying on ABG closure alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.26599\/joto.2026.9540065","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:41:40Z","timestamp":1785134500000},"page":"130-135","source":"Crossref","is-referenced-by-count":0,"title":["Bone conduction threshold improvement after otosclerosis surgery"],"prefix":"10.26599","volume":"21","author":[{"given":"Nina","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Te","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue-Lin","family":"Hsieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingji","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianqiong","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuqing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibo","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11138","reference":[{"issue":"5","key":"ref1","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1097\/MAO.0b013e318280dc78","article-title":"Bone conduction after stapes surgery: Comparison of CO2 laser and manual perforation","volume":"34","author":"C. 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Audiologic outcomes of footplate drillout for obliterative otosclerosis. 2022, 43(1): 29-35.","journal-title":"Otol. Neurotol."},{"issue":"10","key":"ref4","doi-asserted-by":"publisher","first-page":"978","DOI":"10.1097\/MAO.0000000000004042","article-title":"Exoscope-assisted stapedotomy: Evaluation of safety and efficacy","volume":"44","author":"R.M. Conway","year":"2023","unstructured":"R.M. Conway. Exoscope-assisted stapedotomy: Evaluation of safety and efficacy. 2023, 44(10): 978-982.","journal-title":"Otol. Neurotol."},{"issue":"4","key":"ref5","doi-asserted-by":"publisher","first-page":"3628","DOI":"10.1007\/s12070-023-04034-3","article-title":"The clinical picture of otosclerosis and the surgery effect on bone conduction thresholds on audiograms","volume":"75","author":"L. Darjazini Nahas","year":"2023","unstructured":"L. Darjazini Nahas. The clinical picture of otosclerosis and the surgery effect on bone conduction thresholds on audiograms. 2023, 75(4): 3628-3635.","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"issue":"1","key":"ref6","doi-asserted-by":"publisher","first-page":"e165","DOI":"10.1055\/s-0043-1761171","article-title":"Outcomes of endoscopic stapedectomy: Systematic review","volume":"28","author":"A.N. Elsamnody","year":"2024","unstructured":"A.N. Elsamnody. Outcomes of endoscopic stapedectomy: Systematic review. 2024, 28(1): e165-e169.","journal-title":"Int. Arch. Otorhinolaryngol."},{"issue":"5","key":"ref7","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1016\/j.otorri.2015.11.003","article-title":"Evaluaci\u00f3n del cambio en el umbral de la v\u00eda \u00f3sea en pacientes operados de estapedectom\u00eda","volume":"67","author":"L. Garc\u00eda-Iza","year":"2016","unstructured":"L. Garc\u00eda-Iza. Evaluaci\u00f3n del cambio en el umbral de la v\u00eda \u00f3sea en pacientes operados de estapedectom\u00eda. 2016, 67(5): 268-274.","journal-title":"Acta Otorrinolaringol. Esp."},{"issue":"7","key":"ref9","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1017\/S0022215109004745","article-title":"Hearing results of 1145 stapedotomies evaluated with Amsterdam hearing evaluation plots","volume":"123","author":"V.E. Kisilevsky","year":"2009","unstructured":"V.E. Kisilevsky. Hearing results of 1145 stapedotomies evaluated with Amsterdam hearing evaluation plots. 2009, 123(7): 730-736.","journal-title":"J. Laryngol. Otol."},{"issue":"5","key":"ref10","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.1007\/s00405-022-07739-3","article-title":"\u201cHot\u201d vs \u201cCold\u201d endoscopic stapes surgery: A matched case\u2013control study","volume":"280","author":"G. Molinari","year":"2023","unstructured":"G. Molinari. \u201cHot\u201d vs \u201cCold\u201d endoscopic stapes surgery: A matched case\u2013control study. 2023, 280(5): 2257-2263.","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"issue":"8","key":"ref11","doi-asserted-by":"publisher","first-page":"3653","DOI":"10.1007\/s00405-023-07880-7","article-title":"Endoscopic stapedotomy: Classic versus reversal technique","volume":"280","author":"W. Moneir","year":"2023","unstructured":"W. Moneir. Endoscopic stapedotomy: Classic versus reversal technique. 2023, 280(8): 3653-3659.","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"issue":"2","key":"ref12","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.otc.2017.11.001","article-title":"Otosclerosis: Temporal bone pathology","volume":"51","author":"A.M. Quesnel","year":"2018","unstructured":"A.M. Quesnel. Otosclerosis: Temporal bone pathology. 2018, 51(2): 291-303.","journal-title":"Otolaryngol. Clin. 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Neurotol."},{"issue":"1","key":"ref17","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1007\/s12070-023-04126-0","article-title":"Frequency-specific audit of audiological outcomes following stapedotomy for otosclerosis","volume":"76","author":"K. Warhade","year":"2024","unstructured":"K. Warhade. Frequency-specific audit of audiological outcomes following stapedotomy for otosclerosis. 2024, 76(1): 200-207.","journal-title":"Indian J. Otolaryngol. Head Neck Surg."},{"issue":"3","key":"ref18","doi-asserted-by":"publisher","first-page":"353","DOI":"10.5152\/iao.2020.8139","article-title":"Influence of changes in bone-conduction thresholds on speech audiometry in patients who underwent surgery for otosclerosis","volume":"16","author":"A. Wiatr","year":"2020","unstructured":"A. Wiatr. Influence of changes in bone-conduction thresholds on speech audiometry in patients who underwent surgery for otosclerosis. 2020, 16(3): 353-357.","journal-title":"J. Int. Adv. 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