Stapedectomy in congenital stapes fixation: are hearing outcomes poorer? Otolaryngol Head Neck Surg 2006 May;134(5):816-8
Date
05/02/2006Pubmed ID
16647540DOI
10.1016/j.otohns.2005.10.063Scopus ID
2-s2.0-33646081785 (requires institutional sign-in at Scopus site) 35 CitationsAbstract
OBJECTIVE: To evaluate outcomes of stapedectomy surgery for congenital stapes fixation.
STUDY DESIGN: Retrospective chart review.
METHODS: The charts of 463 stapedectomies performed by 1 surgeon from 1996 to 2003 were reviewed. Patients with a history of childhood hearing loss and operative findings consistent with congenital fixation of the stapes were included. Patients with a history of trauma or chronic otitis media and those with otosclerosis were excluded. Thirty-six patients underwent stapedectomy for congenital fixation. Revision cases and those with inadequate postoperative bone or air conduction data were excluded. Inclusion criteria were met for 25 patients. Operative findings and hearing outcomes were evaluated.
RESULTS: The study group was comprised of 25 stapedectomies. Closure of the air-bone gap to less than 10 dB was achieved in 48% of cases, and 80% had closure within 20 dB. A gap of more than 30 dB remained in 3 cases. There were 2 cases of sensorineural hearing loss with worsening of the bone conduction thresholds by 15 dB and 30 dB. There were no instances of perilymph gusher. In addition to an excluded case that was not reconstructed because of facial nerve position, 3 of the included patients were found to have a dehiscent facial nerve at surgery. There were no facial nerve injuries, and fixation of the malleus or incus was not found in any of the included patients. When hearing outcomes were compared with our results for otosclerosis over the same time period, rates of closure to within 10 dB and 20 dB were significantly worse in the congenital group.
CONCLUSION: Closure of the air-bone gap in this population differs from our results in stapedectomy done for otosclerosis. This difference likely reflects subtle anatomic variations in the congenital group that affect the effectiveness of the prosthesis. Despite the difference in results, stapedectomy for congenital fixation remains an effective method to achieve significant hearing improvement in the majority of patients.
EBM RATING: B-3b.
Author List
Massey BL, Hillman TA, Shelton CAuthor
Becky Massey MD Associate Professor in the Otolaryngology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Audiometry
Auditory Threshold
Child
Female
Follow-Up Studies
Hearing Loss, Conductive
Humans
Male
Middle Aged
Otosclerosis
Postoperative Complications
Retrospective Studies
Stapes
Stapes Surgery
Treatment Outcome
