An internally validated prognostic model for success in revision stapes surgery for otosclerosis

Wegner, Inge; Vincent, Robert; Derks, Laura S. M.; Rauh, Simone P.; Heymans, Martijn W.; Stegeman, Inge; Grolman, Wilko

doi:10.1002/lary.27132

Cited by 17 publications

(12 citation statements)

References 39 publications

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“…A recently published multivariable prediction model pointed out that type of the previously performed procedure, primary cause of failure, and type of the prosthesis placed during revision surgery are associated with postoperative success in otosclerosis patients undergoing revision stapes surgery. 26 In our study, previous type of procedure and primary cause of failure were not associated with success. The type of the prosthesis placed during revision surgery did not vary all that much in our study population; 61 cases received an incus-to-oval-window prosthesis, and only 5 cases received a malleus-to-oval-window prosthesis.…”

Section: Discussionmentioning

confidence: 41%

Revision Stapes Surgery in a Tertiary Referral Center: Surgical and Audiometric Outcomes

Blijleven

Wegner

Tange

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: To evaluate pure-tone audiometric results in otosclerosis patients undergoing revision stapes surgery following previous middle ear interventions. Methods: A retrospective cohort study was performed in a tertiary referral center. Consecutive otosclerosis patients who underwent revision stapes surgeries, following previous middle ear interventions, for persistent conductive hearing loss, recurrent conductive hearing loss, or vertigo and had available postoperative pure-tone audiometry were included. Mean pre- and postoperative air conduction, bone conduction, and air-bone gap averaged over 0.5, 1, 2, and 3 kHz were obtained. Audiometric outcomes were obtained at 7 weeks postoperatively. Results: In total, 63 consecutive otosclerosis patients who underwent 66 revision stapes surgeries were included. Air-bone gap improved significantly with a mean gain of 19 dB (95% CI, 15-22). Air conduction improved significantly with a mean gain of 18 dB (95% CI, 14-23). Bone conduction did not change significantly, with a mean deterioration of 0 dB (95% CI, –2 to 1). Air-bone gap closure to 10 dB or less was achieved in 38% of cases and to 20 dB or less in 80% of cases. Indication for surgery, previous type of procedure, primary cause of failure, and current surgical technique were not significantly associated with air-bone gap closure to 10 dB or less. Indication for surgery and primary cause of failure were associated with one another. Conclusions: Compared to the available literature, a slightly larger gain in air conduction and air-bone gap was achieved in our study. Air-bone gap closure to 10 dB or less was achieved less often in our study.

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Section: Discussionmentioning

confidence: 41%

Revision Stapes Surgery in a Tertiary Referral Center: Surgical and Audiometric Outcomes

Blijleven

Wegner

Tange

et al. 2019

Ann Otol Rhinol Laryngol

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“…In the study, the success rate of surgery was reported 95.7%. In the same study, the tympanic perforation after stapedotomy was reported 1.1% [12]. In the present study, 91.4% of patients had hearing improvement as a decrease above 15 db in air bone gap, but the difference in surgery by attending physicians and fellows was not significant, and their complications were not significantly different.…”

Section: Discussionsupporting

confidence: 42%

Determining the Incidence of Complications and Their Causes after Stapedotomy in Patients with Otosclerosis

Mohseni

Daneshi

Asghari

et al. 2019

JPRI

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Introduction: In order to treat the symptoms of otosclerosis, various surgical and medical treatments are suggested. Surgical treatments are the choice. This study aimed to determine the incidence of vertigo and its cause in Iran, and the present study focused on this issue. Methods: This was a prospective cohort study carried out on patients with otosclerosis undergoing stapedotomy referred to Rasoul Akram hospital, Tehran during 2017-18. The patients aged below 18 or those who had a history of vertigo were excluded. Diapasonic and audiometric tests were carried out. The follow-ups included the time of admission (the day after surgery) for the presence of vertigo using visual analogue scale and diapasonic tests, one week after surgery using visual analogue scale and diapasonic tests, and one month after surgery using visual analogue scale and audiometry. The data were imported to SPSS v.22 software and analyzed. Results: The surgical complications that occurred after stapedotomy for patients in this center were as follows: 12.1%of subjects had vertigo one day after surgery, 8.6% had vertigo one week later, and 1.7% had vertigo one month later, thus, the frequency of vertigo was reduced overtime. Meanwhile, 91.4% of the patients had a better sense of hearing and only 1.7% suffered from tympanic membrane perforation. In 8.6% of subjects, there was a disturbance in the taste. Tinnitus was only observed in 5.2% of the surgical patients in this center. Among women, vertigo was higher one day and one week after surgery. Logistic regression showed that age is significant predictor of dizziness one day after surgery (OR: 1.37, P=0.03). Conclusion: According to the results, the frequency of vertigo was decreased overtime. In this study, it was found that the complications of stapedotomy surgery were less than other surgical methods, but those who were older had significantly higher vertigo a week and one day after surgery indicating effective role of age on postoperative complications. Those who underwent surgery by tympanomeatal method had a better vertigo one day and one week after surgery.

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“…Importantly, success in revision stapes surgery is correlated with an accurate diagnosis of the cause of failure . For example, the extent of incus necrosis dictates repair options and ultimately clinical outcomes .…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

Audiologic and surgical outcomes in endoscopic revision stapes surgery

et al. 2019

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An internally validated prognostic model for success in revision stapes surgery for otosclerosis

Abstract: 2b. Laryngoscope, 128:2390-2396, 2018.

Cited by 17 publications

References 39 publications

Revision Stapes Surgery in a Tertiary Referral Center: Surgical and Audiometric Outcomes

Revision Stapes Surgery in a Tertiary Referral Center: Surgical and Audiometric Outcomes

Determining the Incidence of Complications and Their Causes after Stapedotomy in Patients with Otosclerosis

Audiologic and surgical outcomes in endoscopic revision stapes surgery

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