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Audiologic and surgical outcomes in endoscopic revision stapes surgery
Author(s) -
Nassiri Ashley M.,
Yawn Robert J.,
Dedmon Matthew M.,
Tolisano Anthony M.,
Hunter Jacob B.,
Isaacson Brandon,
Rivas Alejandro
Publication year - 2019
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.27786
Subject(s) - medicine , otorhinolaryngology , neurotology , otology , head and neck surgery , general surgery , surgery
When compared to primary stapes surgery, revision stapes surgery has been reported to result in less favorable surgical and audiologic outcomes, with an increased risk of postoperative sensorineural hearing loss (SNHL). Due to the presence of altered anatomy, adhesions, and a previously manipulated oval window, revision stapes surgery is technically challenging. Prior studies have shown that the most common causes of failure after primary stapes surgery include prosthesis dislocation, short or long prosthesis, incus erosion or dislocation, perilymphatic fistula, and ankylosis of the lateral ossicular chain. The success of revision stapes surgery relies on intraoperative identification of the cause for initial surgical failure because a lack of diagnosis has been correlated with negative outcomes. Consequently, adequate visualization and evaluation of the ossicular chain and oval window are essential to accurately diagnose and treat the cause of failure. An endoscopic approach to stapes surgery allows for enhanced visualization of the ossicular chain and oval window. Additionally, endoscopy of the middle ear has been especially useful in diagnosing ossicular malformations, perilymphatic fistulas, and ossicular fixation. Although prior studies have demonstrated similar audiologic and surgical outcomes between endoscopic and microscopic approaches for primary stapes surgery, endoscopic outcomes for revision stapes surgery have not been previously reported. This case series describes the presentation, clinical course, and outcomes of six patients who underwent endoscopic revision stapes surgery.