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Updated: Jun 7, 2026
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Stapedectomy in children: causes and surgical results in 35 cases
Francoise Denoyelle1, Mary Daval, Nicolas Leboulanger
1Service d'ORL Pédiatrique, Hôpital d'Enfants Armand-Trousseau, 26 av du Dr Arnold Netter, 75012 Paris, France. f.denoyelle@trs.aphp.fr
Insights
Congenital stapes fixation is the primary reason for stapedectomy in children under 16. Stapedectomy surgery in pediatric patients yields good, stable hearing results over time.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Stapedectomy is a surgical procedure to restore hearing.
- Understanding the causes and outcomes of stapedectomy in pediatric patients is crucial for effective treatment.
Purpose of the Study:
- To investigate the causes of hearing loss in children undergoing stapedectomy.
- To analyze the short-term, 1-year, and long-term functional results of stapedectomy in patients younger than 16 years.
Main Methods:
- A 10-year retrospective study (1998-2008) of 33 pediatric patients (35 ears) at tertiary care centers.
- Data collected included patient demographics, audiometric results, causes of hearing loss, surgical techniques, and complications.
- Surgical techniques included drill/laser-assisted small fenestra stapedotomy and partial stapedectomy with fascia grafting.
Main Results:
- Congenital stapes fixation was the leading cause (71%) of hearing loss in pediatric stapedectomy patients.
- Otosclerosis was the second most common cause (17%), followed by trauma and osteogenesis imperfecta.
- Early functional results showed a median air-bone gap of 9.8 dB, with 94% rated as good or very good, and results remained stable long-term.
Conclusions:
- Congenital fixation is the predominant indication for stapedectomy in children under 16.
- Stapedectomy in pediatric patients achieves favorable and durable hearing outcomes.
Objectives:
To study children who had undergone stapedectomy at an age younger than 16 years to determine the causes (particularly frequency of congenital anomalies vs otosclerosis) and to analyze the functional results over the short-term, 1-year, and long-term postsurgery time course.
Design:
Ten-year retrospective study covering 1998 to 2008.
Setting:
Pediatric tertiary care centers.
Patients:
A total of 33 patients (35 ears) underwent stapes surgery from October 1998 to October 2008.
Main Outcome Measure:
Sex, age, preoperative and postoperative audiometric test results, associated anomalies, type of surgery (stapedotomy or partial stapedectomy), method of stapes surgery, and complications.
Results:
The median age of patients at surgery was 13.4 years, ranging from 3.3 to 15.9 years. The major cause, which was found in 25 of 35 ears (71%), was nonprogressive conductive hearing loss due to congenital stapes fixation. The second most common cause, which was found in 6 of 35 ears (17%), was otosclerosis with progressive conductive or mixed hearing loss. Three ears presented posttraumatic stapes luxation (1 child aged 3.3 years at surgery). In 1 ear, the cause was osteogenesis imperfecta. Twenty-two ears were treated via the drill or laser-assisted small fenestra technique, and 13 ears were treated by a partial removal of the footplate covered by fascia. Early functional results were good, with a median postoperative air-bone gap of 9.8 dB, and 94% of the results were considered good or very good. There was no significant difference between early, 1-year, and longer-term audiometric results.
Conclusions:
Congenital fixation is the major indication for stapedectomy in children younger than 16 years. Functional results are good and remain stable over time.
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