title: Pediatric stapedectomy: does cause of fixation affect outcomes?
abstract: OBJECTIVE
  To compare outcomes of stapedectomy in patients with congenital stapes fixation versus juvenile otosclerosis.
  
  
  METHODS
  A retrospective chart review was performed from January 1, 1999 until January 1, 2011 to identify patients under 18 years old who underwent a stapedectomy. Age, gender, pre- and postoperative audiograms, intraoperative findings including etiology of stapes fixation, prosthesis type, and complications were recorded.
  
  
  RESULTS
  Twenty-two children were identified who had undergone a stapedectomy (two patients underwent sequential bilateral surgery) resulting in a total of 24 ears. The cause of fixation included juvenile otosclerosis (n=7) and congenital stapes fixation (n=17). The overall mean pre-operative air-bone gap (ABG) was 34.7 dB (SD: 13.5) compared to a postoperative mean ABG of 9.0 (SD: 9.3) (p<0.001). The mean postoperative ABG of 9.6 (SD: 10.5) in the congenital stapes fixation group was similar to the mean postoperative ABG of 7.2dB (SD: 5.4) in children with juvenile otosclerosis (p=0.6). Two patients developed delayed profound sensorineural hearing loss approximately two weeks after surgery. One patient with profound sensorineural hearing loss recovered to a profound mixed hearing loss with a speech discrimination score of 80%.
  
  
  CONCLUSIONS
  Pediatric stapedectomy has comparable results to stapedectomy in adults regardless of the cause of stapes fixation; however, delayed sensorineural hearing loss may be higher in the pediatric population.
authors.affiliation: University of Texas Southwestern Medical Center, Department of Otolaryngology, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States.
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Neilan
authors.forename: Richard W
authors.initials: RW
authors.lastname: Zhang
authors.forename: Peter S
authors.initials: PS
authors.lastname: Roland
authors.forename: Brandon
authors.initials: B
authors.lastname: Isaacson
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Lee
authors.forename: J
authors.initials: J
authors.lastname: Walter Kutz
mesh_terms: D000293:Adolescent; D001299:Audiometry; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010040:Otosclerosis / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013199:Stapes / Q000002:abnormalities*; D013201:Stapes Surgery / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome