title: Primary stapedotomy in children with otosclerosis: A prospective study of 41 consecutive cases.
abstract: OBJECTIVE
  To prospectively evaluate hearing outcomes in children with otosclerosis undergoing primary stapes surgery.
  
  
  METHODS
  A nonrandomized, nonblinded, prospective case series.
  
  
  METHODS
  Thirty-four consecutive pediatric patients who underwent 41 primary stapedotomies for otosclerosis in a tertiary referral center were included. Patients were included when there was evidence of otosclerotic stapes fixation and they had available postoperative pure-tone audiometry. Patients underwent primary stapedotomy with vein graft interposition and reconstruction with a regular piston, bucket handle prosthesis, or total ossicular replacement prosthesis. Hearing results were evaluated using pre- and postoperative four-frequency (0.5, 1, 2, and 4 kHz) audiometry. Air-conduction thresholds, bone-conduction thresholds, and air-bone gaps were measured. Postoperative audiometry was performed at 3, 6, 9, 12, 18, and 24 months after surgery and at a yearly interval thereafter.
  
  
  RESULTS
  Overall, a postoperative air-bone gap closure of 10 dB or less was achieved in 93% of cases and to within 20 dB in 98% of cases. Mean gain in air-conduction threshold was 23 dB for the entire case series, and mean air-bone gap closure was 23 dB. Postoperative sensorineural hearing loss, defined as changes in bone-conduction thresholds exceeding 10 dB, occurred in one case at last follow-up. The bone-conduction threshold deteriorated 13 dB in this case.
  
  
  CONCLUSIONS
  Primary stapedotomy is a safe and feasible treatment option in children with juvenile otosclerosis.
  
  
  METHODS
  4.
authors.affiliation: Jean Causse Ear Clinic, Traverse de Béziers, Colombiers, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Vincent
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Inge
authors.initials: I
authors.lastname: Wegner
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Bernard M D
authors.initials: BM
authors.lastname: Vonck
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Arnold J
authors.initials: AJ
authors.lastname: Bittermann
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Digna M A
authors.initials: DM
authors.lastname: Kamalski
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery.|Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
authors.forename: Wilko
authors.initials: W
authors.lastname: Grolman
mesh_terms: D000293:Adolescent; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction / Q000502:physiology*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010040:Otosclerosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D013201:Stapes Surgery / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Otosclerosis; hearing loss; hearing results; pediatric; pure-tone audiometry; stapedotomy; stapes surgery