More than 70% of revision stapedectomy cases for hearing improvement have had successful closure of their air-bone gap. Since the introduction of the laser 5 years ago, the success rate has increased to 80%. In those specific cases where the laser was required, the success rate increased to 91.4%. Regardless of the revision technique, hearing results were the least successful when the incus could not be used for reconstruction.

On the basis of the available literature, a weak recommendation is made to use intratympanic steroid treatment of sudden hearing loss if oral steroid therapy fails or is contraindicated. The available studies regarding intratympanic steroid treatment of Meniere's disease and tinnitus are inadequate to answer the question of the efficacy of this treatment for these conditions. Higher quality studies are needed.

By using the treatment protocol and definition of hearing recovery of this study, intratympanic dexamethasone does not result in significant hearing improvement for patients with profound ISSNHL. There is a possible trend for improved hearing results if intratympanic treatment is performed within 11 days of onset of hearing loss.

Titanium implants provide comparable hearing improvement compared with other materials. The extrusion rate seems quite low if cartilage interposition graft is inserted. Its ease of handling, biocompatible properties, and sound conducting properties improve its efficacy as an ossicular implant.

Conservative management-"wait and scan"-for selected patients with acoustic neuroma is a reasonable choice of management instead of radiation or microsurgery. In some situations the individual morbidities associated with surgery or radiation make those treatments not in the patient's best interests. A third option is necessary in patients who cannot or do not wish to undergo those other treatments.