Hearing Outcomes of Stapes Surgery in Children With Stapes Fixation and Ossicular Anomalies

Abstract

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.