Revision stapes surgery

Bhardwaj, Bhanu; Kacker, S. K.

doi:10.1017/s0022215100103858

Cited by 26 publications

(24 citation statements)

References 12 publications

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“…Sensorineural hearing loss due to inner ear trauma is more likely to occur during revision surgery. In experienced hands, successful results (postoperative air‐bone gap closure to within 10 dB) have been reported in 18% to 80% of cases, with a mean of approximately 50% in most series 1‐20 . In the same series, the postoperative sensorineural hearing loss (a drop in bone conduction threshold more than 10 dB) was found in the range of 0% to 20% of cases.…”

Section: Introductionmentioning

confidence: 90%

Revision Stapedectomy: Intraoperative Findings, Results, and Review of the Literature

et al. 1997

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Seventy-four revision stapedectomies performed consecutively over 10 years (1986 to 1995) were reviewed retrospectively. The most common intraoperative findings were incus erosion, prosthesis displacement, and oval window closure. Incus erosion was more frequently associated with multiple revisions. The postoperative results were reported using the conventional method (postoperative air minus preoperative bone) as well as the guidelines recently published by the American Academy of Otolaryngology--Head and Neck Surgery (postoperative air minus postoperative bone), with success rates of postoperative air-bone gap closure to within 10 dB after revision surgery of 51.6% and 45.6%, respectively. Patients with persistent conductive hearing loss (large residual air-bone gaps) after primary stapedectomy had poorer postrevision hearing results. Sensorineural hearing loss (defined as a drop in bone pure-tone average of more than 10 dB) occurred in four cases (5.4%). The number of revision surgeries, variations in operative techniques using laser or drill, and the ossicle to which the prosthesis was attached did not statistically affect the postoperative air-bone gaps. These results were compared with previously published data.

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Section: Introductionmentioning

confidence: 90%

Revision Stapedectomy: Intraoperative Findings, Results, and Review of the Literature

et al. 1997

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“…Perilymphatic fistula was reported by Sheehy et al (26) in 16%, Bhardwaj (27) in 1.6%, and Feldman and Schuknecht (28) in 3%. Fistula formation developed more in the Gelfoam group than in the living tissue group (29).…”

Section: Discussionmentioning

confidence: 91%

“…Two cases showed bone closure of the oval window. Sheehy et al (26) and Bhardwaj (27) stated that oval window reopening will cause sensorineural hearing loss.…”

Section: Discussionmentioning

confidence: 99%

Stapes Surgery Outcomes: The Practice of 35 Years

Hancı¹,

Sözen²,

Kayahan³

et al. 2014

Turk Arch Otolaryngol

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Objective: The objective of this study was to review patients who underwent stapes surgery in the Hacettepe University Ear Nose Throat and Head and Neck Surgery Department with subgroups, such as type of surgery, prosthesis used in the surgery, rate of revision, and audiological results. Methods:The data of 35 years were searched, and it was detected that 327 patients (190 females, 137 males) had undergone stapes surgery; the age was ranging between 11-70 years (mean: 39).In our clinic, stapes surgery is performed mostly by transmeatal incision. After entering the middle ear, we almost always look for stapes mobility. If there is mobility in the incus and malleus and no mobility in the stapes, a small fenestra is performed as stapedotomy and prosthesis and placed between the stapedotomy fenestra and incus long arm. To cover the space near the stapedotomy, small bony fragments are placed. In patients who had preoperative and postoperative audiograms, the mean value of 500, 1000, 2000, and 4000 Hz air-bone conduction thresholds of 199 cases were measured and compared.Results: In 62% of 327 patients who were operated on, the air-bone gap was less than 10 dB, less than 15 dB in 88%, and less than 20 dB in 94%. In 6% of patients, there was air-bone conduction gap of more than 20 dB. Revision surgery was performed in 20 patients. Of them, air-bone gap closure was achieved in 60%. One patient had sudden sensorineural hearing loss. There was also a perilymph fistula in one patient who had vertigo.Stapedotomy and using a Teflon piston with autogenous bone are successful methods of recovering conductive-type hearing loss in otosclerosis. In patients with advanced sensorineural hearing loss, a very low air-bone gap or unmeasured air-bone gap is not a contraindication. Conclusion:Stapes surgery (stapedectomy or stapedotomy) is a successful surgery in the case of conductive-type hearing loss with otosclerosis. Complications, such as total sensorineural hearing loss, facial nerve paralysis, and perilymph fistula, could be seen at variable rates, and the surgeon should be cautious, and the patients must be informed about these complications in the pre-operative period. Keywords

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“…Our results were similar with 6.5% bone regrowth. For several authors (17,21), oval window regrowth would be more frequent when obliterative otosclerosis existed during the first intervention. Perilymphatic fistulas represented the primary cause as shown during revisions for cochleovestibular complications.…”

Section: Intraoperative Findingsmentioning

confidence: 99%