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• Preoperative and postoperative hearing results and long-term results of stapedectomy have been investigated in 58 ears (47 patients) with osteogenesis imperfecta. After 3 months, hearing gain had been achieved in 49 (85%) of 58 ears. Twentyseven (68%) of 40 ears followed up for an average of 9.6 years (range, 2 to 24 years) had no deterioration of their immediate postoperative hearing gain. In the other ears, the decrease in hearing gain in the long term was due to progression of the sensorineural component of the hearing loss. Complete closure of the air-bone gap remained unchanged in 26 (70%) of 37 ears. In 5 (9%) of 58 ears the sensorineural component of the hearing loss increased as an immediate result of the operation. In 6 other ears (10%) progressive sensorineural hearing loss was seen only after more than 1 year. A natural course of the disease is assumed as the cause because progressive sensorineural hearing loss has also been seen in the nonoperated on contralateral ears of these patients. ( Arch Otolaryngol Head Neck Surg . 1990;116:317-323)

Between 1968 and 1986 stapes surgery has been performed in the Nijmegen University Department of Otorhinolaryngology in 11 patients (14 ears) with osteogenesis imperfecta. Detailed information about pre- and postoperative hearing levels, findings at surgery, and the follow-up period are presented. In most cases the stapedectomy has been successful.

Background Osteogenesis Imperfecta (OI) is a heritable connective tissue disorder mainly caused by mutations in the genes COL1A1 and COL1A2 and is associated with hearing loss in approximately half of the cases. The hearing impairment usually starts between the second and fourth decade of life as a conductive hearing loss, frequently evolving to mixed hearing loss thereafter. A minority of patients develop pure sensorineural hearing loss. The interindividual variability in the audiological characteristics of the hearing loss is unexplained. Methods With the purpose of evaluating inter- and intrafamilial variability, hearing was thorougly examined in 184 OI patients (type I: 154; type III: 4; type IV: 26), aged 3-89 years, with a mutation in either COL1A1 or COL1A2 and originating from 89 different families. Due to the adult onset of hearing loss in OI, correlations between the presence and/or characteristics of the hearing loss and the underlying mutation were investigated in a subsample of 114 OI patients from 64 different families who were older than 40 years of age or had developed hearing loss before the age of 40. Results Hearing loss was diagnosed in 48.4% of the total sample of OI ears with increasing prevalence in the older age groups. The predominant type was a mixed hearing loss (27.5%). A minority presented a pure conductive (8.4%) or pure sensorineural (12.5%) loss. In the subsample of 114 OI subjects, no association was found between the nature of the mutation in COL1A1 or COL1A2 genes and the occurrence, type or severity of hearing loss. Relatives originating from the same family differed in audiological features, which may partially be attributed to their dissimilar age. Conclusions Our study confirms that hearing loss in OI shows a strong intrafamilial variability. Additional modifications in other genes are assumed to be responsible for the expression of hearing loss in OI.