Revision Stapedectomy

Schmid, Philipp; Häusler, Rudolf

doi:10.1097/mao.0b013e3181b4ecb2

Cited by 45 publications

(11 citation statements)

References 23 publications

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“…The most common intraoperative findings are prosthesis related (22–24). Revision surgery allows the surgeon to address anatomical issues, such as an excessively long prosthesis (23,25). One study reported that in 14% of vertigo revision cases, no intraoperative abnormalities were identified and the PSV persisted (22).…”

Section: Discussionmentioning

confidence: 99%

Resolution of Persistent Post-Stapedotomy Vertigo With Migraine Prophylactic Medication

Moshtaghi

Mahboubi²,

Haidar³

et al. 2017

Otology &Amp; Neurotology

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Objective To describe persistent post-stapedotomy vertigo (PSV) and its treatment using migraine prophylaxis. Patients A retrospective review of all patients with persistent PSV spanning 10 years at a tertiary academic hospital was performed. Patients who experienced persistent vertigo for a minimum of 3 months after surgery were included. Those with possible perilymph fistula, long prosthesis, and benign paroxysmal positional vertigo were excluded. Interventions All patients received instructions on migraine dietary and lifestyle changes and Vitamin B2 and magnesium. In addition, prophylactic treatment with nortriptyline, verapamil, or a combination thereof was started. Main Outcome Measure Changes in vertigo frequency was the main outcome variable. The secondary outcome variables included the time period and medications necessary to achieve symptomatic resolution. Results Four women and one man with an average age of 53 years were identified that met criteria for persistent PSV indicating an incidence of 0.9% at our institution. The onset of vertigo symptoms was on average 20 days postoperatively. All five patients had daily vertigo episodes and experienced complete resolution with no vertigo episodes after treatment. Symptomatic resolution was achieved over an average of 9 weeks after initiating treatments. Conclusions Persistent PSV beyond 3 months is a rare occurrence and its treatment can be challenging when there is no evidence of an underlying pathology. This subset of patients may be suffering from migraine, which was triggered postoperatively. Treatment with migraine prophylaxis in this cohort of patients may result in resolution of vertigo.

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Section: Discussionmentioning

confidence: 99%

Resolution of Persistent Post-Stapedotomy Vertigo With Migraine Prophylactic Medication

Moshtaghi

Mahboubi²,

Haidar³

et al. 2017

Otology &Amp; Neurotology

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“…Likewise, profound SNHL has been reported after an average of 1.7% (range: 0–14%) and 1.8% of stapes revisions (range 0–14%) in reviews of the literature. In this context, it should be noted that the result of 14% in one study with 35 patients is exceptionally high when compared to the rest of the studies [146], [157]. …”

Section: Selected Surgical Proceduresmentioning

confidence: 84%

“…Stapes revision is generally recommended if the air-bone gap exceeds 20 dB [145]. According to the literature, 5–10% of primary stapes operations require revision surgery [146]. …”

Section: Selected Surgical Proceduresmentioning

confidence: 99%

“…A retrospective analysis of 201 stapes revisions in 175 patients described the following intraoperative findings for patients with conductive hearing loss after primary surgery: prosthesis lateralization due to collagen contracture of the oval window neomembrane (53%), partial or complete incus necrosis (33%), reossification of the stapes footplate (31%) and loosening of the loop on the incus (9%) [146]. A prospective study with 279 stapes revisions in 260 patients [150] identified the following causes for conductive hearing loss: …”

Section: Selected Surgical Proceduresmentioning

confidence: 99%

“…For instance, a study with 201 stapes revisions in 175 patients reported an improvement of the air-bone gap in 88% of cases [146]. The risk of profound SNHL following stapes revision has been estimated to be twice as high (2.2%) as compared to primary surgery [156].…”

Section: Selected Surgical Proceduresmentioning

confidence: 99%

See 2 more Smart Citations

Surgery of the ear and the lateral skull base: pitfalls and complications

Schick

Dlugaiczyk

2013

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 12:Doc05; ISSN 1865-1011

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CO₂ laser revision stapedotomy

et al. 2013

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To avoid any manipulation of the conductive hearing chain that may cause sensorineural hearing loss, we adapted the noncontact technique previously introduced by us for use in revision stapedotomy. This technique was successfully applied to improve conductive and sensorineural hearing loss as well as vertigo in first and second revision stapedotomy cases. Because the rate of postoperative complications was comparable to what is achieved with other laser systems, we conclude that the method has at least an equal level of safety. In conclusion, we advocate the use of a noncontact technique as suitable for an early revision of failed stapedotomy.

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Revision Stapedectomy

Abstract: Stapes revisions are more challenging procedures with less perfect results compared with primary operations. Nevertheless, a postoperative hearing improvement was achieved in 88% of our patients. Modern techniques, such as the laser and microdrill, demonstrate their full usefulness.

Cited by 45 publications

References 23 publications

Resolution of Persistent Post-Stapedotomy Vertigo With Migraine Prophylactic Medication

Resolution of Persistent Post-Stapedotomy Vertigo With Migraine Prophylactic Medication

Surgery of the ear and the lateral skull base: pitfalls and complications

CO₂ laser revision stapedotomy

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Revision Stapedectomy

Abstract: Stapes revisions are more challenging procedures with less perfect results compared with primary operations. Nevertheless, a postoperative hearing improvement was achieved in 88% of our patients. Modern techniques, such as the laser and microdrill, demonstrate their full usefulness.

Cited by 45 publications

References 23 publications

Resolution of Persistent Post-Stapedotomy Vertigo With Migraine Prophylactic Medication

Resolution of Persistent Post-Stapedotomy Vertigo With Migraine Prophylactic Medication

Surgery of the ear and the lateral skull base: pitfalls and complications

CO2 laser revision stapedotomy

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CO₂ laser revision stapedotomy