title: Stapedotomy in osteogenesis imperfecta: a prospective study of 32 consecutive cases.
abstract: OBJECTIVE
  To prospectively evaluate hearing outcomes in patients with osteogenesis imperfecta undergoing primary stapes surgery and to isolate prognostic factors for success.
  
  
  METHODS
  A nonrandomized, open, prospective case series.
  
  
  METHODS
  A tertiary referral center.
  
  
  METHODS
  Twenty-five consecutive patients who underwent 32 primary stapedotomies for osteogenesis imperfecta with evidence of stapes fixation and available postoperative pure-tone audiometry.
  
  
  METHODS
  Primary stapedotomy with vein graft interposition and reconstruction with a regular Teflon piston or bucket handle-type piston.
  
  
  METHODS
  Preoperative and postoperative audiometric evaluation using conventional 4-frequency (0.5, 1, 2, and 4 kHz) audiometry. Air-conduction thresholds, bone-conduction thresholds, and air-bone gap were measured. The overall audiometric results as well as the results of audiometric evaluation at 3 months and at least 1 year after surgery were used.
  
  
  RESULTS
  Overall, postoperative air-bone gap closure to within 10 dB was achieved in 88% of cases. Mean (standard deviation) gain in air-conduction threshold was 22 (9.4) dB for the entire case series, and mean (standard deviation) air-bone gap closure was 22 (9.0) dB. Backward multivariate logistic regression showed that a model with preoperative air-bone gap closure and intraoperatively established incus length accurately predicts success after primary stapes surgery.
  
  
  CONCLUSIONS
  Stapes surgery is a feasible and safe treatment option in patients with osteogenesis imperfecta. Success is associated with preoperative air-bone gap and intraoperatively established incus length.
authors.affiliation: *Jean Causse Ear Clinic, Traverse de Béziers, Colombiers, France; and †Department of Otorhinolaryngology - Head and Neck Surgery and ‡Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Vincent
authors.forename: Inge
authors.initials: I
authors.lastname: Wegner
authors.forename: Inge
authors.initials: I
authors.lastname: Stegeman
authors.forename: Wilko
authors.initials: W
authors.lastname: Grolman
mesh_terms: D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction; D005260:Female; D034381:Hearing Loss / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010013:Osteogenesis Imperfecta / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult