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

Blijleven, Esther E.; Wegner, Inge; Tange, R. A.; Thomeer, Hans G. X. M.

doi:10.1177/0003489419853304

Cited by 19 publications

(17 citation statements)

References 30 publications

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“…These results might suggest that, independently from their blood concentration, female hormones might impact on the ligament elasticity improving the ossicular chain movements [ 21 , 22 ]. Furthermore, we found that all the patients that preserved good bone conduction thresholds successfully recovered their auditory function, thus confirming the previous studies about the efficacy of surgery in these type of patients [ 15 , 17 , 18 , 26 , 27 ].…”

Section: Discussionsupporting

confidence: 89%

The effect of female hormone in otosclerosis. A comparative study and speculation about their effect on the ossicular chain based on the clinical results

Ricci

Gambacorta

Lapenna

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose This study aimed at identifying gender differences in the hearing thresholds in a sample of patients with otosclerosis before and after surgery to understand the impact of female hormones on auditory thresholds. Methods This retrospective study analyzed 184 patients (123 women and 61 men) affected by otosclerosis. All the patients were affected by conductive hearing loss and treated by stapedoplasty. Auditory thresholds at the baseline (T0) and one month after surgery (T30) were collected. Air and bone thresholds and Air Bone Gap (ABG) were compared between females and males using one-way ANOVA. Results Statistically significant differences were observed comparing the air threshold at T0 vs T30 both in women and men (p < 0.0001). No statistically significant differences were observed in the bone conduction thresholds before and after surgery. The comparison between females and males showed statistically significant differences both at T0 (p < 0.01) and T30 (p < 0.05) for air conduction thresholds and ABG at 4000 Hz. Conclusion Although stapedoplasty reduced the difference between females and males in the air conduction thresholds and ABG, women showed better recovery of their middle ear function with better auditory thresholds and ABG. The female hormones might positively impact the ligaments of the incudostapedial joint improving chain flexibility. This benefit might explain the statistically significant difference observed in women at 4000 Hz before and after surgery.

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Section: Discussionsupporting

confidence: 89%

The effect of female hormone in otosclerosis. A comparative study and speculation about their effect on the ossicular chain based on the clinical results

Ricci

Gambacorta

Lapenna

et al. 2022

Eur Arch Otorhinolaryngol

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“…The primary causes of failure in this study—including prosthesis displacement, reparative granuloma, lateral chain fixation, extensive fibrotic bands, and a persistently intact footplate—have all been indicated in prior studies, although their relative frequencies vary. 3,4 Most failures in this study were due to prosthesis displacement with or without incus erosion. Cases of prosthesis displacement without incus erosion are likely attributable to technical errors, such as a short prosthesis or inadequate stapedotomy, while cases with incus erosion are more likely to result from ischemic changes to the incus due to overcrimping or tenuous perfusion.…”

Section: Discussionmentioning

confidence: 83%

“…Revision stapes surgery is less likely to succeed than primary surgery, with rates of ABG closure to \10 dB HL varying in recent reports from 40% to 70%. 4,[9][10][11] Our cohort fit into this range, with 66% of patients achieving an ABG \10 dB. In comparison, this degree of hearing improvement is achieved in up to 90% of primary surgery procedures.…”

Section: Discussionmentioning

confidence: 98%

“…6 Outcomes for revision stapes surgery are highly variable, and studies are lacking that examine reasons for revision surgery and their associations with success. 4,7 The purpose of this study was to examine outcomes in revision stapes surgery in a large single-institution cohort. Specifically, we evaluated improvement in hearing and its association with the pattern of postoperative recurrent or persistent hearing loss, initial outcomes after primary surgery, and intraoperative findings during revision.…”

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confidence: 99%

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Revision Stapes Surgery: Hearing Symptoms and Associations With Intraoperative Findings and Outcomes

Luryi

Schettino²,

Michaelides³

et al. 2021

Otolaryngol.--head neck surg.

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Objective Stapes surgery for otosclerosis occasionally requires revision due to recurrent or persistent conductive hearing loss (CHL). This study examines outcomes after revision stapes surgery. Study Design Retrospective review. Setting Single tertiary neurotology center. Methods Patients undergoing revision stapes surgery for otosclerosis from 2008 to 2017 were reviewed. Postoperative air-bone gaps (ABGs) were the primary outcome measure. Results During the study period, 150 patients underwent revision stapes surgery. One hundred patients (67%) had gradually progressive recurrent CHL; 16 (11%), sudden recurrent CHL; 13 (9%), persistent CHL; and 21 (14%), no CHL. For 129 patients with CHL, the mean ABG improved from 23.7 to 9.3 dB ( P < .0005). The most common intraoperative findings for these patients were prosthesis displacement with incus necrosis (38%) or without it (43%), normal anatomy with seemingly good prosthesis placement (6%), and abundant scar tissue (6%). Patients with recurrent hearing loss achieved lower mean ABGs than patients with persistent hearing loss (8.8 vs 13.2 dB, P = .02). There were no associations between onset pattern of CHL or intraoperative findings and hearing outcomes ( P > .05). Four patients (2.7%) developed sensorineural hearing loss after revision, defined as an increase in bone conduction pure tone average ≥15 dB, all of whom had previous replacement of a malpositioned prosthesis. Conclusions Revision stapes surgery confers significant improvement in hearing for patients with persistent and recurrent CHL, although patients with persistent CHL after initial surgery see less improvement with revision.

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“…La cirugía de revisión de otoesclerosis ha sido uno de los criterios de exclusión en la selección de la muestra, y los porcentajes de éxito obtenidos se suelen analizar diferenciándolos de los de la cirugía primaria. Es por ello que sería interesante realizar una evaluación en próximos estudios (8,12,13).…”

Section: Discussionunclassified

Otosclerosis surgery: results of the last 5 years of the University Hospital of Jaén

Jurado-Anillo

2022

Actual. Med.

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Objectives: The main aim of our study is to know the percentage of success of otosclerosis surgery in our center. We have assessed it by calculating the post surgical air-bone gap from pure tone audiometries which were realised one year after the surgery. In addition, we have also estimated if there are differences between stapedectomy and stapedotomy procedures as well as possible complications such as new hearing loss at high frequencies or percentage of hearing aid needed after surgery. Methods: A retrospective cohort study was carried out with a total of 45 ears. All of them were diagnosed with otosclerosis and treated at the ENT department of Hospital Universitario de Jaén from 2015 to 2019. In our study, we have considered two cohorts depending on the procedure used, either stapedotomy or stapedectomy. Afterwards, a pure tone audiometry was performed one year after the surgery and the post- surgical air-bone gap was calculated, estimating the pure tone average from both air and bone postsurgical conduction. Results: Surgery success (air-bone gap <20dB) was achieved in 90.3% of the cases using stapedectomy technique while a 85.7% with stapedotomy technique. Altogether, considering both groups, the success of the surgery was 88.9%. There were no statistically significant differences between both techniques. Conclusions: After the results of our study, we can affirm that stapedotomy and stapedectomy have similar success rates in terms of decreasing the post-surgical air-bone gap and achieving clinical improvement of hearing, showing no statistically significant differences between them.

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

Cited by 19 publications

References 30 publications

The effect of female hormone in otosclerosis. A comparative study and speculation about their effect on the ossicular chain based on the clinical results

The effect of female hormone in otosclerosis. A comparative study and speculation about their effect on the ossicular chain based on the clinical results

Revision Stapes Surgery: Hearing Symptoms and Associations With Intraoperative Findings and Outcomes

Otosclerosis surgery: results of the last 5 years of the University Hospital of Jaén

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