Yun Suk An1, Kwang-Sun Lee2. 1. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, South Korea. 2. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, South Korea. Electronic address: kslee2@amc.seoul.kr.
Abstract
OBJECTIVES: The aims of this study were to review the causes of stapes fixation in children undergoing stapes surgery and to analyze the results of stapes surgery in children in the short term, at 1 year, and over the long term. METHODS: The medical records of 18 children (28 ears) who had undergone stapes surgery between January 1999 and December 2012 were retrospectively reviewed. The medical history, computed tomography results, intraoperative findings, video clips, and hearing outcomes of all patients were reported. RESULTS: The mean age of patients was 11.1 years (range, 5.9-15.3 years). Congenital stapes fixation (22/28 ears, 79%) and juvenile otosclerosis (6/28 ears, 21%) were responsible for all cases of stapes fixation. Intraoperatively, abnormal facial nerves that were downwardly displaced over the stapes footplate were noted in four ears. Incudostapedotomy was performed in 24 ears, malleostapedotomy in three, and partial stapedectomy in one. The early postoperative audiometric outcome was favorable in 21 ears (87.5%). There was no significant difference between early postoperative (87.5%), 1 year postoperative (91%), and long term (92.3%) favorable audiometric results. There was no significant difference in the postoperative hearing results between patients with congenital stapes fixation and juvenile otosclerosis. CONCLUSION: Congenital stapes fixation was diagnosed in 22 (79%) ears and juvenile otosclerosis in six (21%) ears from a series of 28 ears that were operated on for stapes fixation. Facial nerve anomalies were found in four of 22 ears (18%) that had congenital stapes fixation. There was no difference in the postoperative hearing results between patients with congenital stapes fixation and juvenile otosclerosis. Regardless of the cause of stapes fixation, stapedotomy is a safe and effective procedure for managing the condition.
OBJECTIVES: The aims of this study were to review the causes of stapes fixation in children undergoing stapes surgery and to analyze the results of stapes surgery in children in the short term, at 1 year, and over the long term. METHODS: The medical records of 18 children (28 ears) who had undergone stapes surgery between January 1999 and December 2012 were retrospectively reviewed. The medical history, computed tomography results, intraoperative findings, video clips, and hearing outcomes of all patients were reported. RESULTS: The mean age of patients was 11.1 years (range, 5.9-15.3 years). Congenital stapes fixation (22/28 ears, 79%) and juvenile otosclerosis (6/28 ears, 21%) were responsible for all cases of stapes fixation. Intraoperatively, abnormal facial nerves that were downwardly displaced over the stapes footplate were noted in four ears. Incudostapedotomy was performed in 24 ears, malleostapedotomy in three, and partial stapedectomy in one. The early postoperative audiometric outcome was favorable in 21 ears (87.5%). There was no significant difference between early postoperative (87.5%), 1 year postoperative (91%), and long term (92.3%) favorable audiometric results. There was no significant difference in the postoperative hearing results between patients with congenital stapes fixation and juvenile otosclerosis. CONCLUSION: Congenital stapes fixation was diagnosed in 22 (79%) ears and juvenile otosclerosis in six (21%) ears from a series of 28 ears that were operated on for stapes fixation. Facial nerve anomalies were found in four of 22 ears (18%) that had congenital stapes fixation. There was no difference in the postoperative hearing results between patients with congenital stapes fixation and juvenile otosclerosis. Regardless of the cause of stapes fixation, stapedotomy is a safe and effective procedure for managing the condition.