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Updated: May 5, 2026
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
The surgical results of stapes fixation in children
1Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, South Korea.
Insights
Stapes surgery in children is effective for both congenital stapes fixation and juvenile otosclerosis, with consistently favorable hearing outcomes long-term. Stapedotomy is a safe procedure for improving hearing in pediatric patients.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Surgical Innovation
Background:
- Stapes fixation, a condition affecting hearing, can occur in children due to congenital anomalies or juvenile otosclerosis.
- Surgical intervention, specifically stapes surgery, is considered for these cases to restore auditory function.
- Understanding the causes and surgical outcomes in pediatric populations is crucial for effective treatment planning.
Purpose of the Study:
- To identify the primary causes of stapes fixation in children undergoing stapes surgery.
- To evaluate the short-term, 1-year, and long-term hearing results following stapes surgery in pediatric patients.
- To analyze the safety and efficacy of stapedotomy for stapes fixation in children.
Main Methods:
- Retrospective review of medical records for 18 children (28 ears) who underwent stapes surgery between 1999 and 2012.
- Analysis of patient history, computed tomography (CT) scans, intraoperative findings, and video documentation.
- Audiometric assessment of hearing outcomes at various postoperative intervals.
Main Results:
- Congenital stapes fixation (79%) and juvenile otosclerosis (21%) were the main causes of stapes fixation in this pediatric cohort.
- Favorable audiometric results were observed in 87.5% early postoperatively, with sustained high success rates at 1 year (91%) and long-term (92.3%).
- No significant difference in hearing outcomes was found between congenital stapes fixation and juvenile otosclerosis, or across different postoperative time points.
Conclusions:
- Congenital stapes fixation and juvenile otosclerosis are the predominant causes of stapes fixation requiring surgery in children.
- Facial nerve anomalies were noted in a subset of congenital cases.
- Stapedotomy demonstrates consistent safety and efficacy in improving hearing outcomes for children with stapes fixation, irrespective of the underlying cause.
Objectives:
The aims of this study were to review the causes of stapes fixation in children undergoing stapes surgery and to analyze the results of stapes surgery in children in the short term, at 1 year, and over the long term.
Methods:
The medical records of 18 children (28 ears) who had undergone stapes surgery between January 1999 and December 2012 were retrospectively reviewed. The medical history, computed tomography results, intraoperative findings, video clips, and hearing outcomes of all patients were reported.
Results:
The mean age of patients was 11.1 years (range, 5.9-15.3 years). Congenital stapes fixation (22/28 ears, 79%) and juvenile otosclerosis (6/28 ears, 21%) were responsible for all cases of stapes fixation. Intraoperatively, abnormal facial nerves that were downwardly displaced over the stapes footplate were noted in four ears. Incudostapedotomy was performed in 24 ears, malleostapedotomy in three, and partial stapedectomy in one. The early postoperative audiometric outcome was favorable in 21 ears (87.5%). There was no significant difference between early postoperative (87.5%), 1 year postoperative (91%), and long term (92.3%) favorable audiometric results. There was no significant difference in the postoperative hearing results between patients with congenital stapes fixation and juvenile otosclerosis.
Conclusion:
Congenital stapes fixation was diagnosed in 22 (79%) ears and juvenile otosclerosis in six (21%) ears from a series of 28 ears that were operated on for stapes fixation. Facial nerve anomalies were found in four of 22 ears (18%) that had congenital stapes fixation. There was no difference in the postoperative hearing results between patients with congenital stapes fixation and juvenile otosclerosis. Regardless of the cause of stapes fixation, stapedotomy is a safe and effective procedure for managing the condition.
