Evidence map›Paper›PMID 42771570›Full record

ArticleAudiology & neuro-otology2026

Symons and Fanning Classification in Otosclerosis and Its Relation to Audiologic Parameters, Stapes Footplate Thickness, and Round Window Involvement.

Justus Müller-Goebel, Rahel Bertschinger, Nathalie Nierobisch, David Bächinger, Flurin Pfiffner, Christof Röösli, Alexander Huber, Adrian Dalbert

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Article in Audiology & neuro-otology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Justus Müller-GoebelDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland, justus.mueller-goebel@usz.ch.
Rahel BertschingerDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Nathalie NierobischFaculty of medicine, University of Zurich, Zurich, Switzerland.
David BächingerDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Flurin PfiffnerDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Christof RöösliDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Alexander HuberDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.
Adrian DalbertDepartment of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOtosclerosis is a clinical diagnosis despite mostly performed preoperative imaging. Radiological classifications and findings correlate heterogeneously with audiometric parameters. The objective of this study was to investigate the inter- and intrarater reliability between two raters of different departments regarding the widely used Symons and Fanning classification (SFC) and correlate this with further radiological features and audiometric parameter.

methodsThis was a retrospective data analysis conducted on 63 surgical confirmed otosclerotic ears from 56 patients in a single tertiary referral center. Radiological classification and findings were assessed independently by two investigators, a neuroradiologist and ear, nose, and throat specialist, from a preoperative cone beam computed tomography (CBCT). Inter- and intrarater reliability of the SFC and its correlation were compared with hearing level, round window involvement, and stapes footplate thickness.

resultsInterrater reliability slightly increased over a 6-month period and was considered to be weak at both time points. There was no correlation between the SFC of each rater, between the rater matches and the hearing level. Round window involvement was seen in 16% (10/63) of patients and showed no association with preoperative hearing level or audiometric outcome. Higher grading according to the SFC revealed no association with stapes footplate thickness.

conclusionThe reproducibility of the SFC on CBCT has been found to be limited when grading was performed independently by two specialists from different disciplines. No significant associations were observed between radiologic staging and stapes footplate thickness, and in relation to hearing level or round window involvement. The rater or timepoint was no decisive factor. These findings indicate that the predictive value of the classification for preoperative audiologic counseling remains conditionally applicable.

Indexed as

Cone beam computed tomographyGradingHearing outcomeOtosclerosisRound windowStapesStapes footplateSymons and Fanning

Identifiers

PMID42771570
PMCPMC13690320

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