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Predictive Factors in Pediatric Stapedectomy
Author(s) -
Welling D. Bradley,
Merrell James A.,
Merz Meredith,
Dodson Edward E.
Publication year - 2003
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200309000-00018
Subject(s) - stapedectomy , footplate , medicine , otosclerosis , tympanosclerosis , stapes , retrospective cohort study , surgery , otorhinolaryngology , prosthesis , fixation (population genetics) , population , middle ear , mechanical engineering , environmental health , engineering
Abstract Objective/Hypothesis The objective of the study was to investigate predictive factors in the postoperative hearing outcomes in pediatric stapedectomy. Study Design 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.