Long-term follow-up of stapedectomy in children and adolescents

Otosclerosis presenting in children and adolescents is uncommon. Typically, otosclerosis presents as a slowly progressive conductive hearing loss in the third to fourth decade. Many well-documented studies have demonstrated excellent long-term hearing results with stapedectomy. Although stapedectomy is highly effective, the rare complications may be devastating. Thirty-one patients, 21 years or younger, underwent 40 stapedectomies for otosclerosis at our institution. The average age at surgery was 16 years, with a range of 7 to 21 years. Postoperative results showed an average improvement in air-bone gap of 22 dB. Clinical and audiologic data were collected over a mean follow-up period of 25 years. There was no statistically significant difference in air-bone gap when comparing the immediate postoperative gap (measured 2 months after stapedectomy) with the last gap recorded (mean, 25 years after stapedectomy). Fifty percent of the ears operated on maintained an air-bone gap within 10 dB at the last follow-up, and an additional 40% maintained a 10- to 20-dB gap. There were no significant relationships between demographic or clinical factors and "success" (gap <= 10 dB) or long-term gap closure. Our data demonstrate that stapedectomy is an effective method for closing the air-bone gap in children and adolescents with otosclerosis, and long-term results parallel those of adults, showing maintenance of excellent gap closure. This review represents the largest population with the longest follow-up in children who underwent stapedectomy for the treatment of otosclerosis.