Effects of treatment of otosclerosis in children

Henryk Skarżyński¹, Maciej Mrówka¹, Paulina Młotkowska-Klimek¹, Bożena Skarżyńska²

Summary
Otosclerosis in children is not a rare condition, however, many authors recommend only patient assessment in those cases and no surgical treatment before puberty. The aim of the present study was to analyze hearing results of stapedotomy in children with otosclerosis and to compare the results with those obtained in adults. The material at Otorhinolaryngosurgery Center, the International Center of Hearing and Speech, consisted of 37 children (38 ears) and adolescents under 16 years of age who were surgically operated for otosclerosis, and followed up for at least 6 months. Almost all the patients underwent stapedotomy with implantation of a teflon-piston prosthesis; stapes mobilization was performed in two cases. Pre- and postoperative hearing assessment included frequencies 500, 1000, 2000 and 4000 Hz. In 4 ears advanced obliterative otosclerotic lesions were found. Otosclerosis accompanied, the so-called, small middle ear congenital malformations (lack of the stapes suprastructure); one patient had a coexisting oto- and tympanosclerosis but without any tympanosclerotic foci in the oval window recess. In 6 ears, hearing impairment was of a mixed type, in other cases it was only conductive hearing loss. Mean preoperative air-bone gap reached 27.4 dB. Following surgery, a gap closure within 10 dB was achieved in 35 ears. An overclosure effect was obtained in 12 patients, with an average value of 3.2 dB. Mean hearing gain in all patients was 29.2 dB. The follow-up period (6-36 months) showed that the mean value of the reported air-bone gap was 3.8 dB, however, in 35 ears the hearing thresholds have been still better than those from before the surgical operation. Reoperations were performed in 4 patients in order to remove adhesions or to restore the connection between the prosthesis and footplate. Postoperative hearing results, not worse than in adults, seem to support the concept of employing surgical treatment in all children with recognized otosclerosis.

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