Although ossicular reconstruction in children may carry a risk of fail
ure because of recurrent middle ear disease, the procedure offers the
potential for restoring binaural hearing during the school years when
it is so critical. Of a series of 45 reconstructions with total and pa
rtial ossicular replacement prostheses, 6 were extruded for a surgical
success rate of 87%. Of the successful cases, 74% had air-bone gaps o
f 30 dB or better, and 74% had speech reception thresholds of 30 dB or
better on initial postoperative audiogram. Outcomes for these childre
n were comparable with those reported for adults, supporting the value
of early reconstruction.