The influence of age on the results of stapedectomy.

In a retrospective study, we investigated the results of 384 stapedectomies performed between 1962 and 1989. The purpose was to determine the possible influence of age on the postoperative functional result. The operative technique uniformly consisted of a total stapedectomy, seal of the oval window with perichondrium and replacement of the stapes by a free tragal cartilage graft. The audiometric data at 0.5, 1, 2, and 4 kHz were compared. The patients were divided into five groups based upon chronological age: under 30, 30-40, 41-50, 51-60, over 60 years. Although the preoperative airbone gap (ABG) increased with age at all frequencies, and thus the chance for surgery to improve the ABG, the youngest group showed the best improvement in ABG (P less than 0.05). Using a technique with total removal of the footplate, bone conduction thresholds improved in the frequencies up to 2 kHz. At 4 kHz, they deteriorated in the four oldest groups. The greatest improvement in bone conduction thresholds occurred in the youngest group of patients (P less than 0.05), with a parallel decline in age and postoperative results occurring. The causes of these differences are not yet clear, although spontaneous recovery and greater resistance to operative trauma in the younger age groups might be of influence.