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A review of 308 cases of revision stapedectomy
Author(s) -
Hammerschlag Paul E.,
Fishman Andrew,
Scheer Allan Austin
Publication year - 1998
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 - 10.1097/00005537-199812000-00006
Subject(s) - stapedectomy , medicine , otosclerosis , prosthesis , surgery , neurotology , vertigo , sensorineural hearing loss , bone conduction , otology , population , hearing loss , audiology , otorhinolaryngology , environmental health , head and neck surgery
Objective/Hypothesis : Identify causes of primary and revision stapedectomy failure in 308 patients, assess whether these are different based on source of initial surgery, and evaluate hearing results in revision stapedectomy to improve outcome. Study Design : Retrospective, nonrandomized chart review of patients undergoing revision stapedectomy in a referral otology practice in a large metropolitan region. Materials and Methods : Intraoperative findings, preoperative and postoperative revision stapedectomy air and bone conduction pure‐tone averages, speech discrimination scores, postoperative air‐bone gaps, complications, and repeated revisions were noted in 308 patients. Results : Leading causes of primary stapedectomy failure included dislocated prosthesis (24.4%), inadequate prosthesis length (14%), long process resorption (14%), and fibrous adhesions (13.6%). Revision stapedectomy air‐bone gaps were less than 10 dB in 80% and greater than 30 dB in 6.8% of cases. Increased sensorineural hearing loss occurred in 0.8% of revision stapedectomy cases. Five of seven cases of vertigo associated with primary stapedectomy resolved after revision surgery. Conclusion : Revision stapedectomy by experienced surgeons is highly effective in attaining successful air‐bone gap closure in 80% and improved closure in 84.8% of operative cases. Risk of vertigo and/or sensorineural hearing loss was not any higher in this patient population when compared with reports of primary stapedectomy.