Pediatric stapedectomy: Does cause of fixation affect outcomes?

Objective: To compare outcomes of stapedectomy in patients with congenital stapes fixation versus juvenile otosclerosis. Methods: A retrospective chart review was performed from January 1, 1999 until January 1, 2011 to identify patients under 18 years old who underwent a stapedectomy. Age, gender, pre- and postoperative audiograms, intraoperative findings including etiology of stapes fixation, prosthesis type, and complications were recorded. Results: Twenty-two children were identified who had undergone a stapedectomy (two patients underwent sequential bilateral surgery) resulting in a total of 24 ears. The cause of fixation included juvenile otosclerosis (. n=. 7) and congenital stapes fixation (. n=. 17). The overall mean pre-operative air-bone gap (ABG) was 34.7. dB (SD: 13.5) compared to a postoperative mean ABG of 9.0 (SD: 9.3) (. p<. 0.001). The mean postoperative ABG of 9.6 (SD: 10.5) in the congenital stapes fixation group was similar to the mean postoperative ABG of 7.2. dB (SD: 5.4) in children with juvenile otosclerosis (. p=. 0.6). Two patients developed delayed profound sensorineural hearing loss approximately two weeks after surgery. One patient with profound sensorineural hearing loss recovered to a profound mixed hearing loss with a speech discrimination score of 80%. Conclusions: Pediatric stapedectomy has comparable results to stapedectomy in adults regardless of the cause of stapes fixation; however, delayed sensorineural hearing loss may be higher in the pediatric population.