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Hearing Outcomes of Stapes Surgery in Children With Stapes Fixation and Ossicular Anomalies
Byung Chul Kang1, Ja Yoon Ku2, Joong Ho Ahn2
1Department of Otorhinolaryngology-Head and Neck Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan.
Insights
Stapes surgery in children with stapes fixation shows good hearing outcomes, with better results when ossicular continuity is maintained. Successful hearing improvement is achievable with appropriate diagnosis and surgical intervention.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Stapes fixation is a condition affecting hearing in children.
- Surgical intervention aims to restore hearing by addressing stapes fixation.
Purpose of the Study:
- To evaluate hearing outcomes in pediatric patients following stapes surgery for stapes fixation.
- To identify factors influencing surgical success in this population.
Main Methods:
- Retrospective study involving 49 patients (66 ears) under 15 years old.
- Analysis of pre- and post-operative hearing levels (air conduction, bone conduction, air-bone gap).
- Statistical analysis using paired t test and Mann-Whitney U test.
Main Results:
- Overall successful hearing results (air-bone gap <20 dB) were achieved in 75.8% of cases.
- Patients with isolated stapes fixation had better outcomes (82.0% success) compared to those with combined ossicular anomalies (56.3% success).
- Significant reduction in air-bone gap was observed post-surgery in both groups.
Conclusions:
- Hearing loss is more severe in children with stapes fixation and concurrent ossicular anomalies.
- Ossicular continuity, particularly the incus, is crucial for successful stapes surgery.
- Stapes surgery offers good hearing restoration for children with stapes fixation when properly diagnosed and performed.
Objectives:
To investigate hearing outcomes after stapes surgery in children with stapes fixation.
Study Design:
Retrospective study.
Setting:
Tertiary referral center.
Patients:
Forty-nine patients (66 ears) aged less than 15 years who received stapes surgery.
Interventions:
Stapes surgery.
Main Outcomes And Measures:
Preoperative symptoms, bilateral involvement, pure-tone hearing levels, and perioperative complications were analyzed using paired t test and Mann-Whitney U test.
Results:
The chief complaint of all patients was hearing disturbance. Sixteen ears were diagnosed with stapes fixation and an additional congenital ossicular anomaly and 50 ears had only stapes fixation. Preoperative mean bone conduction and air conduction thresholds were 12.0 ± 5.8 dB and 60.9 ± 10.9 dB, respectively. The mean air-bone gap (ABG) was 48.9 ± 12.0 dB in patients with stapes fixation and an ossicular anomaly. The postoperative mean ABG was 23.6 ± 14.5 dB, and the ABG closure was 25.3 ± 18.2 dB. In patients with stapes fixation only, the preoperative mean bone conduction and air conduction thresholds were 14.3 ± 7.5 dB and 49.6 ± 9.5 dB, respectively, and the mean ABG was 35.5 ± 9.6 dB. The postoperative mean ABG was 14.4 ± 10.3 dB, and the ABG closure was 16.2 ± 16.1 dB. The successful results (ABG <20 dB) were 75.8% overall, 56.3% for fixation and an ossicular anomaly, and 82.0% for fixation only.
Conclusions:
In children with stapes fixation, hearing loss was worse when the fixation was combined with an ossicular anomaly. Ossicular continuity, especially of the incus, is the most important factor for successful stapes surgery. Appropriate diagnosis and surgical intervention can lead to good results for children with stapes fixation.
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