Related Experiment Video
Updated: Oct 8, 2025
The Microscopic Transcanal Approach in Stapes Surgery Revisited
Published on: February 16, 2022
Outcomes in primary and revision surgery for pediatric onset stapedial pathology
Zachary G Schwam1, Amy Schettino2, Dennis I Bojrab3
1Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, 1 Gustave L. Levy Place, Box 1189, New York, NY 10029, United States of America.
Objectives:
To analyze audiometric outcomes of surgery for pediatric onset stapedial pathology (POSP).
Study Design:
Retrospective cohort study.
Setting:
Single-institution database.
Methods:
Retrospective analysis of 809 stapes procedures performed at a single high-volume tertiary referral otology practice, 75 of which were POSP cases.
Results:
Oval window drillout for thick footplate and aborting the procedure were more common in POSP cases compared to the rest of the cohort (28.0% versus 9.8% [p < .001] and 5.3% versus 1.2% [p = .007], respectively). Postoperative complications were rare. Postoperative Air-Bone Gap (pABG) closure to ≤20 dB was significantly lower in the POSP group (80.0% versus 89.0%, p = .021). Rates of sensorineural hearing loss (SNHL) were not different between the two groups. Poor audiometric outcomes in the POSP group were largely driven by revision cases; pABG≤10 dB was 60.3% in primary cases but only 11.8% in revisions (p < .001), and postoperative SNHL was significantly higher in revisions (29.4% versus 0.0%, p < .001). In multivariate analysis, POSP was not a predictor of successful closure of the pABG at either level, nor did it predict significant postoperative SNHL.
Conclusions:
Surgery for pediatric onset stapedial pathology had significantly worse audiometric outcomes, particularly in revision cases, as compared to the rest of the cohort.
