Surgical Intervention for Congenital Absent Oval Window

Abstract

Objectives: Congenital absent oval window is an uncommon condition that results in significant conductive hearing loss in the pediatric population. Treatment outcomes and results following surgery are still not well established in light of the limited cases that have been published in the literature. This study aims to evaluate the outcomes following surgical intervention of patients with congenital absent oval window in a single institution. Methods: This is a retrospective review of patients who underwent surgical exploration and treatment for congenital absent oval window from 2000 to 2013 in a single institution. Results: Twelve patients were diagnosed with congenital absent oval window. Six of these patients were affected bilaterally. Of the 19 ears affected, 13 were operated on. Eight ears were successfully treated following stapedotomy and insertion of prosthesis. The average pure-tone audiogram for these patients was 62.6 prior to the operation. Following surgery, the average pure-tone level was 22.4. Five of the ears that were operated on showed minimal improvement. Of these 5 ears, 3 were unsuitable for insertion of prosthesis due to unfavorable position of the incus. Two patients underwent stapedotomy with Teflon wire prosthesis insertion. However, this failed to improve hearing levels. Conclusions: Congenital absence of oval window is an uncommon condition that can lead to significant disruption to hearing. Surgical intervention by means of stapedotomy and prosthesis insertion may lead to significant improvement in hearing levels selected patients. However, it may be technically unsuitable for others.