Study of Binaural Squelch Effect in Unilateral Otosclerosis

Study Overview
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Brief Summary
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Patients with unilateral transmission hypoacusis due to otosclerosis undergoing stapedectomy surgery will be prospectively included. They will be undergoing a free field vocal audiometry using the Oldenburg MATRIX software to evaluated the squelch effect gain between audiometry before and after 9months after surgery. Our hypothesis is to show a squelch effect with the rehabilitation of the binaural audition.

Detailed Description
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Otosclerosis is one of the main causes of transmission hypoacusis. It can be treated with stapedectomy surgery. But the understanding ability in noise has not been really studied. The Oldenburg MATRIX test is a well know test in audiology and allow to study the understanding in noise. This study included all the patients coming in our center for stapedectomy for otosclerosis with controlateral audition under 30 decibels (dB) loss. They will all undergo the MATRIX test in three situations: vocal material and noise from the front of the patient (S0N0 situation); vocal material from the front and noise from the bad-earing side (S0N-90 situation); vocal material from the front and noise from the good-earing side (S0N90 situation). This might give three informations: -Squelch effect which is the difference between Speech Reception Threshold (SRT) in S0N90 situation at 9month after surgery and before surgery. The squelch effect is the ability of cortical discrimination to extract spatial cues and information providing from two different sources. So we considered the situation before surgery as a unilateral condition and the surgery rehabilitation as a bilateral condition. Head Shadow effect which is the difference between S0N90 and S0N-90 audiometry situations. The head shadow effect is the difference in the Speech Reception Threshold (SRT) due to diffraction effect of the physical sound wave. Binaural benefit which is the difference between S0N0 situation after and before surgery. The binaural benefit is the SRT gain of both ear with same threshold comparing to a gap of threshold between the two ears. The patients will also filled two questionnaires of quality of life: Abbreviated Profile of Hearing Aid Benefit (APHAB) and Speech and Spatial Questionnaire (SSQ). The aim is to show the benefit of the surgery in otosclerosis for comprehension in noise.

Official Title
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Study of Binaural Squelch Effect Among Patients Undergoing Unilateral Otosclerosis Surgery: Comparison of Understanding in Noise Before-after Surgery

Conditions
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Otosclerosis of Middle Ear, Unilateral Hearing Loss

Intervention / Treatment
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* Procedure: stapedectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosis of otosclerosis controlateral audiometry under 30dB loss the ear to be operated with a transmission over 30dB Exclusion Criteria: otosclerosis which has already operated on the ear studied other cause of transmission hypoacusis transmission after surgery other 30dB

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: stapedectomy|Stapedectomy as described in literature with stapes removal, Carbon Dioxide (CO2) laser platinectomy and placement of a prothesis(piston) between the incus long process and the stapes footplate|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measure of squelch effect 9 months after surgery | Speech reception threshold between S0N90 situation after and before surgery | 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Measure of shadow effect 9 months after surgery | Comparison of Speech reception threshold between (S0N90) - (S0N-90) between 9months after surgery and before surgery | 9 months | 
| Measure of binaural benefit 9 months after surgery | Comparison of Speech reception threshold S0N0 between 9months after surgery and before surgery | 9 months | 
| improving quality of life : Abbreviated Profile of Hearing Aid Benefit | comparison of the global score and the four sub-scales: aversiveness; reverberation; background noise; ease of communication between 3 months after surgery and before surgery | 9 months | 
| Improving quality of life : Speech and Spatial Questionnaire | comparison of the global score and the three sub-scale: speech hearing; spatial hearing; qualities of hearing | 9 months | 
| Measure of squelch effect 3 months after surgery | Speech reception threshold between S0N90 situation after and before surgery | 3 months | 
| Measure of binaural benefit 3 months after surgery | Comparison of Speech reception threshold S0N0 between 3 months after surgery and before surgery | 3 months | 
| Measure of shadow effect 3 months after surgery | Comparison of Speech reception threshold between (S0N90) - (S0N-90) between 3 months after surgery and before surgery | 3 months | 
| improving quality of life : Abbreviated Profile of Hearing Aid Benefit | comparison of the global score and the four sub-scale: aversiveness; reverberation; background noise; ease of communication between 3 months after surgery and before surgery | 3 months | 
| Improving quality of life : Speech and Spatial Questionnaire | comparison of the global score and the three sub-scale: speech hearing; spatial hearing; qualities of hearing between 3 months after surgery and before surgery | 3 months |