Isolated congenital stapes ankylosis: Surgical results in a consecutive series of 39 ears

Objectives: We describe the audiometric results after stapes surgery in a consecutive series of patients with isolated stapes footplate ankylosis. Methods: We performed a retrospective analysis of charts from 1986 to 2001 in a tertiary referral center, focusing on audiometric results. Results: A total of 28 patients (39 ears) underwent stapedotomy or stapedectomy, and 5 patients (5 ears) had a syndromal diagnosis. Overall, we observed a mean gain in air conduction threshold of 21 dB (from 46 to 25 dB) and a mean postoperative air-bone gap of 14 dB (mean preoperative air bone gap, 36 dB). The postoperative air-bone gap was 10 dB or less in 46% of cases, in agreement with results reported in the literature. Moreover, the audiometric results remained stable. In the group of ears with a syndrome, the mean gain in air conduction threshold was only 12 dB (range, -13.8 to 32.5 dB), which was a worse outcome than that in the nonsyndromic ears. Conclusions: Surgery for isolated congenital stapes footplate ankylosis provides satisfactory audiometric outcomes. The postoperative air-bone gap was 10 dB or less in 18 of the 39 ears (46%) and 20 dB or less in 29 of the 39 ears (74%). Most ears had some sensorineural impairment (10 to 20 dB), which influenced the final hearing level after surgery. Preoperative assessment is mandatory to search for syndromal diagnoses, which might be important for patient counseling and prognosis.