Predictive factors in pediatric stapedectomy.
OBJECTIVE
The objective of the study was to investigate predictive factors in the postoperative hearing outcomes in pediatric stapedectomy.


METHODS
Retrospective case series. The study was performed in a tertiary academic otological practice.


METHODS
The outcome of 66 stapedectomies in children 17 years of age and younger were analyzed according to the 1995 American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium guidelines. Factors evaluated included patient age, underlying diagnosis (tympanosclerosis, otosclerosis, congenital fixation), type of footplate graft and type of prosthesis used, associated ossicular abnormalities, and revision surgery.


RESULTS
The mean postoperative air-bone gap following stapedectomy in children with tympanosclerotic footplate fixation (24.9 dB [+/-11 dB]) was significantly worse than in patients with an underlying diagnosis of congenital stapes fixation (15.7 dB [+/-9 dB]) or otosclerosis (13.1 dB [+/-3 dB]) (P =.024). Revision stapedectomy was also associated with a poorer outcome, but patient age and prosthesis and graft type did not contribute to the outcome in a statistically significant manner.


CONCLUSIONS
Pediatric patients with stapes fixation resulting from tympanosclerosis showed poorer outcomes from stapedectomy than patients with congenital or otosclerotic fixation. Outcomes for congenital or otosclerosis fixation more nearly matched the outcomes in the literature for adult series.
Welling
D Bradley
DB
Department of Otolaryngology, The Ohio State University, Columbus, USA. Welling.1@osu.edu
Merrell
James A
JA
Merz
Meredith
M
Dodson
Edward E
EE
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013201:Stapes Surgery