Outcomes in primary and revision surgery for pediatric onset stapedial pathology

Am J Otolaryngol. 2022 Mar-Apr;43(2):103362. doi: 10.1016/j.amjoto.2021.103362. Epub 2021 Dec 23.

Abstract

Objectives: To analyze audiometric outcomes of surgery for pediatric onset stapedial pathology (POSP).

Study design: Retrospective cohort study.

Setting: Single-institution database.

Methods: Retrospective analysis of 809 stapes procedures performed at a single high-volume tertiary referral otology practice, 75 of which were POSP cases.

Results: Oval window drillout for thick footplate and aborting the procedure were more common in POSP cases compared to the rest of the cohort (28.0% versus 9.8% [p < .001] and 5.3% versus 1.2% [p = .007], respectively). Postoperative complications were rare. Postoperative Air-Bone Gap (pABG) closure to ≤20 dB was significantly lower in the POSP group (80.0% versus 89.0%, p = .021). Rates of sensorineural hearing loss (SNHL) were not different between the two groups. Poor audiometric outcomes in the POSP group were largely driven by revision cases; pABG≤10 dB was 60.3% in primary cases but only 11.8% in revisions (p < .001), and postoperative SNHL was significantly higher in revisions (29.4% versus 0.0%, p < .001). In multivariate analysis, POSP was not a predictor of successful closure of the pABG at either level, nor did it predict significant postoperative SNHL.

Conclusions: Surgery for pediatric onset stapedial pathology had significantly worse audiometric outcomes, particularly in revision cases, as compared to the rest of the cohort.

Keywords: Pediatric onset stapedial pathology; Stapedectomy; Stapedotomy.

MeSH terms

  • Bone Conduction
  • Child
  • Humans
  • Otosclerosis* / surgery
  • Reoperation
  • Retrospective Studies
  • Stapes
  • Stapes Surgery* / methods
  • Treatment Outcome