Surgical treatment in children with otosclerosis and congenital stapes fixation: our experience and outcome

Aim: To evaluate outcomes of stapes surgery in children with congenital stapes fixation and juvenile otosclerosis. Methods: A retrospective chart review was performed from 1987 to 2013 to identify patients under 18 years old who underwent a stapes surgery. Patients' age, gender, pre- and postoperative audiograms, intraoperative findings including aetiology of stapes fixation, prosthesis type, and complications were analysed. Results: 18 children (6 - 17 years old), all with bilateral conductive hearing loss were identified and 34 stapes surgeries were performed (two patients underwent surgery only on one side). The cause of fixation included juvenile otosclerosis in 88% and congenital stapes fixation in 12%. The mean pre-operative air-bone gap (ABG) was 36,24 dB (SD: 10,86) compared to a postoperative mean ABG of 7,74 (SD: 3,3) (p < 0.000). The profound sensorineural hearing loss was not observed in long-term follow-up. Conclusions: Paediatric stapes surgery has comparable results to stapedectomy in adults regardless of the cause of stapes fixation; however, the better hearing outcome was observed for cases of juvenile otosclerosis rather than congenital stapes fixation.