Pediatric stapedectomy: does cause of fixation affect outcomes?

Area of Science:

• Otolaryngology
• Pediatric Otology
• Surgical Outcomes

Background:

• Stapes fixation, a common cause of conductive hearing loss in children, can result from congenital anomalies or juvenile otosclerosis.
• Stapedectomy is a surgical procedure to correct hearing loss caused by stapes fixation.

Purpose of the Study:

• To compare the surgical outcomes of stapedectomy in pediatric patients with congenital stapes fixation versus juvenile otosclerosis.
• To evaluate the efficacy and safety of stapedectomy in children for different etiologies of stapes fixation.

Main Methods:

• Retrospective chart review of patients under 18 who underwent stapedectomy between 1999 and 2011.
• Data collected included age, gender, pre- and postoperative audiograms, etiology of stapes fixation, prosthesis type, and complications.
• Audiometric outcomes, specifically air-bone gap (ABG), were analyzed.

Main Results:

• Twenty-four stapedectomies were performed in 22 children (7 with juvenile otosclerosis, 17 with congenital stapes fixation).
• Overall mean postoperative ABG improved significantly (34.7 dB pre-op to 9.0 dB post-op, p<0.001).
• Postoperative ABG was similar between congenital stapes fixation (9.6 dB) and juvenile otosclerosis (7.2 dB) groups (p=0.6). Two patients experienced delayed profound sensorineural hearing loss.

Conclusions:

• Stapedectomy in children yields comparable hearing results to adults, irrespective of the cause of stapes fixation.
• The pediatric population may have a higher incidence of delayed sensorineural hearing loss following stapedectomy.
• Stapedectomy is an effective treatment for hearing loss due to stapes fixation in children.