Revision Stapes Surgery: A Critical Evaluation

Çokkeser, Yaşar; Naguib, Maged B.; Arístegui, Miguel; Saleh, Essam; Landolfi, Mauro; Russo, Alessandra; Sanna, Mario

doi:10.1177/019459989411100414

Cited by 18 publications

(27 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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“…One of them is that fi brous adhesion tissue in the oval window is a result of a mucous irritation from postoperative infl ammation or it is a reaction to a foreign-material (10,15).…”

Section: Discussionmentioning

confidence: 99%

Revision operations after previous stapes surgery for persisting hearing loss

Skrivan¹,

Čada²,

Kluh³

et al. 2014

BLL

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Abstract:Objectives: The aim of the study was to fi nd out the reasons of the recurrent or persisting hearing loss after previous stapes surgery indicated for otosclerosis. Background: Revision stapes surgery is a relatively safe surgical method. Recurrent or persisting conductive hearing loss is commonly caused by prosthesis dislocation and adhesions in the oval window. Hearing loss is directly proportional to the number of previous operations. Method: Retrospective analysis of 48 patients after revision stapes surgery was done over a period of 4 years (2005)(2006)(2007)(2008). Improvement of the hearing and the reasons of a previous surgery failure were studied. Results: Results were compared to the other studies. The main reason of the failed surgery was adhesions and dislocation of the prosthesis. The mean postoperative air-bone gap was 12.0 dB. A mean postoperative air-bone gap closure within 10 dB occurred in 24 cases (55.8 %), between 11-20 dB occurred in 11 cases (25.6 %) and above 20 dB in 8 cases (18.6 %). The original prosthesis was replaced with a new one in 41 (95.3 %) cases. In 2 cases (4.7 %), previous prostheses were left in place and fi xed by a ionomer glass cement to the long process of incus. Conclusion: Revision stapes surgery is a relatively safe surgical procedure allowing to improve hearing. The number of previous stapes surgery deteriorates hearing (p < 0.05) (Tab. 4, Ref. 20). Text in PDF www.elis.sk.

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“…Os exames audiométricos 8,9,11,18 realizados no pré-operatório foram a audiometria tonal e vocal, a imitanciometria e o SRT, sendo esses exames repetidos no pós-operatório para sabermos da existência de ganho auditivo ou não 10,11 . Durante algumas revisões de estapedectomia usamos os diapasões em 512Hz e 1024Hz após o ato cirúrgico, para sabermos se a prótese estava no lugar, com conseqüente presença de boa audição do paciente.…”

Section: Materials E Métodounclassified

“…Nessas revisões não usamos o laser [12][13][14][15][16] e mantivemos a técnica tradicional da cirurgia 1,2,[17][18][19][20] , com o emprego de ganchos especializados, usando raramente brocas afiadas para a abertura da base do estribo. A prótese empregada nas revisões foi na grande maioria a de teflon de 0,6mm ou 0,4mm de espessura e também em alguns casos a prótese de aço e teflon.…”

Section: Introductionunclassified

Cirurgia revisional de 74 casos de estapedectomia/estapedotomia

Mello

Azevedo

2003

Rev. Bras. Otorrinolaringol.

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OBJETIVO: O objetivo deste estudo é o de identificar as diversas causas que nos obrigam a novo procedimento cirúrgico. Apesar de várias alterações técnicas como platinectomia total, platinectomia parcial, interposição óssea, fenestra na platina e o emprego de vários tipos de próteses, os problemas continuam a existir, talvez também pelo pouco treinamento feito pelos residentes nos Centros Universitários, onde o número de cirurgias estapedianas vem caindo ano a ano, o que leva à pouca experiência destes residentes em sua vida futura. FORMA DE ESTUDO: Avaliação Retrospectiva. MATERIAL E MÉTODO: Baseou-se em 74 casos de revisões de estapedectomia, realizadas em 68 pacientes, sendo 47 ouvidos submetidos à primeira revisão e 4 ouvidos submetidos à uma segunda revisão, todos operados anteriormente pelo autor, de uma população de 725 estapedectomias realizadas na clínica privada e 282 estapedectomias realizadas no Hospital Universitário Antônio Pedro (HUAP) - Universidade Federal Fluminense/Niterói-RJ, de julho de 1980 a junho de 1999. Acrescentamos mais 21 casos operados de primeira revisão e de 2 casos operados de segunda revisão oriundos de outros serviços. RESULTADOS: Considerando todos os casos de revisões cirúrgicas realizadas, os ganhos auditivos obtidos foram os seguintes: em 78,3% dos pacientes os ganhos auditivos alcançados foram de até 20dB; em 10,8% dos pacientes de 20dB a 25dB; em 8,2% dos pacientes acima de 25dB, tendo ocorrido anacusia em 2,7% dos pacientes. A avaliação auditiva incluiu o limiar aéreo-ósseo de 250 a 8000Hz com a discriminação vocal e o SRT, sendo que nas freqüências de 500, 1000 e 2000Hz os limiares das vias aérea e óssea foram calculados através dos audiogramas realizados nos pré e pós-operatórios. Os resultados auditivos pós-operatórios dependem da afecção cirúrgica encontrada, principalmente pela presença ou ausência da bigorna e pela reobliteração óssea na janela do vestíbulo. Fizemos o acompanhamento audiológico de todos os ouvidos operados após seis meses da cirurgia e de sessenta e seis ouvidos operados com um ano de cirurgia e com oito pacientes não retornando ao segundo exame.

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Revision Stapes Surgery: A Critical Evaluation

Cited by 18 publications

References 12 publications

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

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

Revision operations after previous stapes surgery for persisting hearing loss

Cirurgia revisional de 74 casos de estapedectomia/estapedotomia

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