Outcomes of Primary Pediatric Stapedotomy. Issue 8 (September 2019)

• Record Type: Journal Article
• Authors: Page, Joshua Cody; Gau, Victoria L.; Allsopp, Tristan; King, DeAnne; Jervis-Bardy, Joshua; Dornhoffer, John L.
• Is Part Of: Otology & neurotology. Volume 40:Issue 8(2019)
• Publication Date: 2019-09
• Subjects: Congenital stapes footplate fixation -- Juvenile otosclerosis -- Pediatric stapedotomy -- Pediatric stapes surgery -- Pediatric tympanosclerosis -- Tympanosclerosis; Otology -- Periodicals; Ear -- Diseases -- Periodicals; Skull base -- Surgery -- Periodicals; 617.8005
• DOI: 10.1097/MAO.0000000000002331
• Languages: English
• ISSNs: 1531-7129

Abstract

Abstract : Objective: To review a single institution experience with pediatric stapedotomy for juvenile otosclerosis (JO), congenital stapes footplate fixation (CSFF), or tympanosclerosis. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: Pediatric patients undergoing surgery for stapes fixation from 2001 to 2017. Main Outcome Measures: Hearing result based on preoperative, first postoperative, and final postoperative pure-tone average air-bone gap (PTA-ABG). Age, sex, diagnosis, procedure performed, prosthesis, and ossicular anomalies were considered. Results: A total of 59 children (4–16 years of age) underwent surgery for stapes fixation (67 ears), with an average postoperative audiogram out to 2.88 years. Final postoperative ABG for tympanosclerosis (30.4 dB ± 10.9 dB) showed some improvement but the outcome was significantly worse than in CSFF (21.0 dB ± 11.4 dB) ( p = 0.020) and JO (22.8 dB ± 14.9 dB). Conclusion: Our data suggest, that in our clinic, surgery for stapes fixation is safe to perform in children. While we achieved desirable results for JO and CSFF, patients with tympanosclerosis showed a statistically worse hearing outcome. Tympanosclerosis deserves special consideration and may be better served with a malleovestibulopexy, total ossicular replacement prosthesis (TORP), or amplification in lieu of traditional stapes surgery.