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.

STUDY DESIGN:

A nonrandomized, open, prospective case series.

SETTING:

A tertiary referral center.

PATIENTS:

Twenty-five consecutive patients who underwent 32 primary stapedotomies for osteogenesis imperfecta with evidence of stapes fixation and available postoperative pure-tone audiometry.

INTERVENTION:

Primary stapedotomy with vein graft interposition and reconstruction with a regular Teflon piston or bucket handle-type piston.

MAIN OUTCOME MEASURES:

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.

CONCLUSION:

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: Robert Vincent, Inge Wegner, Inge Stegeman, Wilko Grolman
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 35 Issue 10 Pg. 1785-9 (Dec 2014) ISSN: 1537-4505 [Electronic] United States
• PMID: 24751750 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Audiometry, Pure-Tone
• Auditory Threshold
• Bone Conduction
• Female
• Hearing Loss (etiology, surgery)
• Humans
• Male
• Middle Aged
• Osteogenesis Imperfecta (complications, surgery)
• Prospective Studies
• Stapes Surgery (methods)
• Treatment Outcome
• Young Adult