Supplementary Material for: Fifteen-Year Follow-Up of Stapedotomy Patients: Audiological Outcomes and Associated Factors in a Middle Income Country

Objective: To evaluate the short-term (postoperative), medium-term (5 years), and long-term (10 and 15 years) audiometric results of patients who underwent stapedotomy and to determine specific factors associated with better postoperative outcomes. Methods: This study is a retrospective case review of 486 ears with surgically confirmed stapes fixation who underwent microscopic small fenestra stapedotomy. Preoperative, postoperative, and medium- and long-term air conduction (AC), bone conduction (BC), and air-bone gap (ABG) were assessed. Postoperative factors associated with better postoperative outcomes were evaluated. Results: At 10- and 15-year follow-ups, ABG, AC, and BC were significantly deteriorated but clinically preserved in comparison with postoperative results. According to a multiple quantile regression, younger age was associated with better postoperative results at 0.25 kHz (p = 0.003) and 4 kHz (p = 0.028) and a smaller preoperative ABG was associated with better audiometric results at 0.25 kHz (p = 0.048), 0.5 kHz (p = 0.001), and 4 kHz (p = 0.001). In addition, younger age (p = 0.001 for AC and p < 0.001 for BC) and preoperative AC PTA (p < 0.001 for AC) were significantly associated with better postoperative AC and BC PTA. Conclusions: Stapedotomy surgery provides short-, medium-, and long-term hearing benefits in our studied cohort. ABG, AC, and BC thresholds obtained after the surgery are clinically preserved in 5-, 10-, and 15-year follow-ups, with an age-expected BC deterioration. Smaller preoperative ABG and younger age were positive predictors for better postoperative ABG. Future research should address long-term subjective and quality of life outcomes.**研究目的**：评估接受镫骨足板造孔术（stapedotomy）患者的短期（术后即刻）、中期（术后5年）及长期（术后10年、15年）听力学结局，并明确与更佳术后预后相关的特异性因素。**研究方法**：本研究为回顾性病例分析，纳入486例经手术证实为镫骨固定且接受显微镜下小窗镫骨足板造孔术的耳部病例。对术前、术后即刻及中、长期的气导（air conduction, AC）、骨导（bone conduction, BC）与气骨导差（air-bone gap, ABG）进行检测评估，并分析与更佳术后预后相关的术后影响因素。**研究结果**：在术后10年及15年随访中，气骨导差、气导与骨导阈值虽出现具有统计学意义的恶化，但相较于术后即刻检测结果，其临床获益仍得以保留。经多元分位数回归分析显示，更年轻的年龄与0.25kHz（p=0.003）及4kHz（p=0.028）频段的更佳术后听力学结局相关；更小的术前气骨导差则与0.25kHz（p=0.048）、0.5kHz（p=0.001）及4kHz（p=0.001）频段的更佳听力学结局相关。此外，更年轻的年龄（气导相关p=0.001，骨导相关p<0.001）与术前气导纯音听阈均值（p<0.001，气导相关）均与更佳的术后气导及骨导纯音听阈均值显著相关。**研究结论**：在本研究纳入的队列中，镫骨足板造孔术可使患者获得短期、中期及长期的听力获益。术后检测得到的气骨导差、气导及骨导阈值在术后5年、10年及15年随访中均得以临床保留，仅出现与年龄相符的预期骨导阈值恶化。更小的术前气骨导差与更年轻的年龄均为更佳术后气骨导差的正向预测因子。未来的研究可聚焦于长期主观听力结局及生活质量相关指标。