Congenital stapes ankylosis associated with another ossicular chain anomaly: Surgical results in 30 ears

Objective: To describe the audiometric results after stapes surgery in a consecutive series of patients with stapes footplate ankylosis combined with another ossicular middle ear anomaly. Study Design: A retrospective analysis of charts collected between 1986 and 2001. Setting: A tertiary referral center. Patients: A total of 25 patients (30 ears) underwent exploratory tympanotomies and ossicular reconstruction. Main Outcome Measure: Audiometric results. Results: Overall, a mean gain in air conduction of 18 dB (from 49 dB to 31 dB) and a mean postoperative airbone gap (ABG) of 20 dB (mean preoperative ABG, 40 dB) were observed. The ABG closure was 20 dB or less in 70% of cases, which is in agreement with the few results reported in the literature. Moreover, the audiometric results remained stable. In the group of ears with a syndrome, the mean gain of air conduction was only 19 dB, which was comparable to that observed among nonsyndromic ears. Conclusions: Surgery for congenital stapes footplate ankylosis with a concomitant ossicular chain anomaly can provide worthwhile hearing improvement. The ABG closure was 20 dB or less in 21 of 30 ears (70%). Most ears had some sensorineural impairment (10-20 dB), which influenced the final hearing level after surgery. Over recent decades, the technique of the malleostapedotomy procedure has been improved. Preoperative assessment is mandatory for syndromal diagnoses, which might be important for patient counseling and prognosis.