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Updated: Dec 17, 2025
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Outcomes Following Revision Stapes Surgery in Children: A Single-Surgeon, Single-Center 15-Year Experience
Joshua Jervis-Bardy1, Victoria L Gau, Tristan Allsopp
1Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Insights
Revision stapes surgery in children can safely improve hearing, especially when preoperative imaging suggests a dislodged prosthesis. This procedure is beneficial for congenital stapes fixation and tympanosclerosis.
Area of Science:
- Otolaryngology
- Pediatric Surgery
Background:
- Congenital stapes fixation (CSF) and tympanosclerosis (TS) can cause hearing loss in children.
- Revision stapes surgery is sometimes necessary for these conditions.
Purpose of the Study:
- To review outcomes of revision stapes surgery in pediatric patients.
- To identify predictors of successful hearing outcomes in revision stapes surgery.
Main Methods:
- Retrospective chart review of 15 pediatric patients undergoing revision stapes surgery.
- Analysis of pre- and post-operative pure-tone average air-bone gap (PTA-ABG) and speech recognition threshold (SRT).
Main Results:
- Mean PTA-ABG improved by 11.9 dB and SRT by 12.3 dB.
- Better outcomes were associated with a history of trauma, extruding prosthesis, or CT findings of malpositioned prosthesis.
- No significant sensorineural hearing loss occurred postoperatively.
Conclusions:
- Revision stapes surgery is safe in experienced hands for pediatric patients.
- Preoperative assessment for prosthesis extrusion or malpositioning can predict better hearing outcomes.
Objective:
To review a single surgeon experience with revision pediatric stapes surgery for congenital stapes fixation (CSF) and tympanosclerosis (TS). Secondly, to determine whether hearing outcomes following revision surgery may be predicted by a thorough work-up aimed at assessing whether an extruded or malpositioned prosthesis is likely to be encountered intraoperatively.
Setting:
Tertiary referral center.
Study Design:
Retrospective chart review.
Patients:
Fifteen patients having revision surgery for fixation of the stapes footplate over a 15-year period.
Main Outcome Measures:
Hearing results based on pre- and post-revision pure-tone average air-bone gap (PTA-ABG) and speech recognition threshold testing (SRT).
Results:
Overall, the mean improvement of PTA-ABG following revision surgery was 11.9 dB (standard deviation [SD] 15.2) while SRTs improved by a mean of 12.3 (SD 19.9). Outcomes were significantly better in patients who reported a history of trauma following their initial surgery, when there was otoscopic evidence of an extruding or extruded prosthesis and/or a pre-revision CT (where performed) suggested an extruded or malpositioned prosthesis. No patients had a significant postoperative sensorineural hearing loss.
Conclusion:
Revision stapes surgery in children is a safe procedure in experienced hands which nonetheless should only be contemplated in patients in whom preoperative work-up suggests an extruded or malpositioned prosthesis is likely to be encountered intraoperatively.
