LAUSR

Abstract Background Otosclerosis causes progressive hearing loss, with stapes surgery being the most effective treatment. However, the influence of age on postoperative outcomes remains debated. Objective To evaluate the impact of age on hearing outcomes following stapes surgery. Methods This retrospective study included patients who underwent primary stapes surgery (2010–2024), excluding those with revision surgeries or confirmed cochlear otosclerosis. Pre- and postoperative pure-tone audiometry assessed air conduction (AC), bone conduction (BC), and air-bone gap (ABG) across age groups. Results This study included 177 patients (188 ears) aged 18–68 years. Significant improvements in AC thresholds and ABG closure were observed across all age groups (p < 0.05). BC thresholds improved significantly in patients <50 years. Linear regression revealed a modest negative correlation between age and AC improvement (R2 = 0.18, p = 0.006). Despite smaller gains in older patients, both age groups demonstrated substantial improvements AC thresholds and ABG, with minimal changes in BC thresholds. No significant differences were found between younger and older groups in changes in BC, AC, or ABG closure (all p > 0.05). Conclusion Stapes surgery significantly improves hearing outcomes across all ages, especially in AC thresholds and ABG closure. Age should not be a contraindication if audiological criteria are met.