International Journal of Pediatric Otorhinolaryngology
Volume 73, Issue 12 , Pages 1712-1717, December 2009

Hearing results of stapedotomy and malleo-vestibulopexy in congenital hearing loss☆

  • Vitaly E. Kisilevsky

      Affiliations

    • Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Canada
    • Corresponding Author InformationCorresponding author at: 8N-Room 873,Toronto General Hospital, 200 Elizabeth Street, Toronto, M5G 2C4 Canada. Tel.: +1 416 340 4630; fax: +1 416 340 3327.
    • ,
  • Neil A. Bailie

      Affiliations

    • University Health Network, University of Toronto, Canada
    • ,
  • Sunil N. Dutt

      Affiliations

    • University Health Network, University of Toronto, Canada
    • Apollo Hospitals Bangalore, India
    • ,
  • Jerry J. Halik

      Affiliations

    • Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Canada
    • Markham-Stouffville Hospital, Canada

Received 23 July 2009; received in revised form 26 August 2009; accepted 3 September 2009.

Abstract 

Aims

To analyze hearing results of surgical treatment of hearing loss associated with the congenital stapes ankylosis with or without malformations of ossicular chain.

Study design

Retrospective chart review.

Methods

The charts of 1369 stapedotomies performed by senior author (JH) from 1991 to 2006 were reviewed. In 40 cases operative findings were consistent with isolated congenital stapes fixation or associated with middle ear malformations. The modified stapedotomy technique was employed in 33 cases and malleo-vestibulopexy was used in 7 cases. Operative findings were standardized according to Cremers’ classification. The outcomes of 40 surgeries were analyzed according to the 1995 AAO-HNS Committee on Hearing and Equilibrium guidelines. High frequency hearing results on 4, 8 and 12kHz were reported in addition to standard frequencies. Results of stapedotomies and malleo-vestibulopexies were calculated separately. Surgical complications were described.

Results

The mean post-operative air conduction (AC) was 33dB, bone conduction (BC) 22dB and speech reception thresholds (SRT) 31dB. Closure of the air–bone gap (ABG) to within 10dB was achieved in 24/40 (60%) of cases. Lack of improvement was observed in 3/40 (8%) patients. In 26/32 (81%) of cases with potential for bilaterally serviceable hearing it was achieved. In 24/40 (60%) of cases symmetrical hearing with interaural difference of less than 10dB was demonstrated.

Conclusion

Significant hearing gain in patients with congenital stapes ankylosis makes surgical treatment a valuable adjunct or an alternative to hearing aids in selected cases.

Keywords: Hearing loss conductive, Middle ear surgery, Otosclerosis, Stapedotomy

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☆ This material has never been published and is not currently under evaluation in any other peer-reviewed publication.

PII: S0165-5876(09)00472-8

doi:10.1016/j.ijporl.2009.09.005

International Journal of Pediatric Otorhinolaryngology
Volume 73, Issue 12 , Pages 1712-1717, December 2009

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