| | Surgery to Improve Hearing Loss (Stapedectomy) at Gundersen Lutheran
Impact
For people with hearing loss caused by abnormal growth of the bones in the ear (otosclerosis), surgery (Stapedectomy) is extremely effective and restores hearing to normal levels.
Aim
Ninety percent of patients with otosclerosis who have a Stapedectomy procedure will have closure of air-bone gap less than 10dB with total sensorineural hearing loss less than 1%.
Results
Conclusions
1. Ninty-nine percent of patients achieved better than 10 decibel air gap closure. These results are compariable to the Cleveland Clinic benchmark based on confidence interval analysis and simulation tests.
2. Over half of patients having stapedectomy achieve air bone gap closure of 0 dB.
Activity leader
Steve Overholt, MD - sloverho@gundluth.org
Next steps
Continue to monitor to ensure high levels of success with this procedure are maintained.
Background
There are three small bones in your ear that are part of a person’s hearing process. The one closest to the inner ear is the stapes. A disease, otosclerosis, can cause hearing difficulty because of extra growth of bone on the stapes. This makes it inflexible and causes it to stick to the other small bones. The vibration does not get transferred to the inner ear and a person can’t hear well. This is known as conductive hearing loss. Stapedectomy is a surgery repairing the damaged bone and joining the bones together again. This should improve the patient’s hearing.
Methods/Measures
A retrospective chart review of patients with CPT codes for Stapedectomy, otosclerosis and conductive hearing loss from 12/15/2000 to 4/6/2007 was done measuring pre and post audiogram (hearing test) results. 95% confidence interval: (97.2%, 100%) for GL determined by simulation with 10000 repetitions. This interval does not overlap with 91% so evidence indicates a statistically significant difference.
Benchmark
US News & World Report ranked the Cleveland Clinic Head and Neck Institute among the top ten programs in the United States in 2005. It is one of the largest otolaryngology programs in the United States.1
References:
1. Cleveland Clinic Quality Measures 2005 edition.
Acknowledgements:
Lisa Wied, Administrative Director, Otolaryngology
Margaret Bitschura, Supervisor, Otolaryngology
Patti Anderson, RN, Quality Improvement |