The effect of female hormone in otosclerosis. A comparative study and speculation about their effect on the ossicular chain based on the clinical results

Purpose This study aimed at identifying gender diferences in the hearing thresholds in a sample of patients with otosclerosis before and after surgery to understand the impact of female hormones on auditory thresholds. Methods This retrospective study analyzed 184 patients (123 women and 61 men) afected by otosclerosis. All the patients were afected by conductive hearing loss and treated by stapedoplasty. Auditory thresholds at the baseline (T0) and one month after surgery (T30) were collected. Air and bone thresholds and Air Bone Gap (ABG) were compared between females and males using one-way ANOVA. Results Statistically signifcant diferences were observed comparing the air threshold at T0 vs T30 both in women and men (p<0.0001). No statistically signifcant diferences were observed in the bone conduction thresholds before and after surgery. The comparison between females and males showed statistically signifcant diferences both at T0 (p<0.01) and T30 (p<0.05) for air conduction thresholds and ABG at 4000 Hz. Conclusion Although stapedoplasty reduced the diference between females and males in the air conduction thresholds and ABG, women showed better recovery of their middle ear function with better auditory thresholds and ABG. The female hormones might positively impact the ligaments of the incudostapedial joint improving chain fexibility. This beneft might explain the statistically signifcant diference observed in women at 4000 Hz before and after surgery.