Related Experiment Video
Updated: May 1, 2026
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Stapedotomy in osteogenesis imperfecta: a prospective study of 32 consecutive cases
Robert Vincent1, Inge Wegner, Inge Stegeman
1*Jean Causse Ear Clinic, Traverse de Béziers, Colombiers, France; and †Department of Otorhinolaryngology - Head and Neck Surgery and ‡Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands.
Objective:
To prospectively evaluate hearing outcomes in patients with osteogenesis imperfecta undergoing primary stapes surgery and to isolate prognostic factors for success.
Study Design:
A nonrandomized, open, prospective case series.
Setting:
A tertiary referral center.
Patients:
Twenty-five consecutive patients who underwent 32 primary stapedotomies for osteogenesis imperfecta with evidence of stapes fixation and available postoperative pure-tone audiometry.
Intervention:
Primary stapedotomy with vein graft interposition and reconstruction with a regular Teflon piston or bucket handle-type piston.
Main Outcome Measures:
Preoperative and postoperative audiometric evaluation using conventional 4-frequency (0.5, 1, 2, and 4 kHz) audiometry. Air-conduction thresholds, bone-conduction thresholds, and air-bone gap were measured. The overall audiometric results as well as the results of audiometric evaluation at 3 months and at least 1 year after surgery were used.
Results:
Overall, postoperative air-bone gap closure to within 10 dB was achieved in 88% of cases. Mean (standard deviation) gain in air-conduction threshold was 22 (9.4) dB for the entire case series, and mean (standard deviation) air-bone gap closure was 22 (9.0) dB. Backward multivariate logistic regression showed that a model with preoperative air-bone gap closure and intraoperatively established incus length accurately predicts success after primary stapes surgery.
Conclusion:
Stapes surgery is a feasible and safe treatment option in patients with osteogenesis imperfecta. Success is associated with preoperative air-bone gap and intraoperatively established incus length.
