Success Rate in Revision Stapes Surgery for Otosclerosis

Abstract

Revision stapes surgery is less likely to be successful than the primary operation. Closure of the air-bone gap to within 10 dB was achieved in 52.4% of patients. The success rate was better in cases where the original prosthesis was replaced with a new one. The risk for decreased bone-conduction threshold does not seem to be higher than in primary surgery.

Prospective Electrophysiologic Findings of Round Window Stimulation in a Model of Experimentally Induced Stapes Fixation

“…Revisions, however, are associated with an increased risk for SNHL (up to 20%) and deafness (up to 14%). Success rates diminish further with increasing number of revision attempts (10).…”

Evaluation of efficacy of otosclerosis surgery on hearing outcomes

“…Bazı çalışmalarda hastaların yaklaşık %12'sinde protezin yerinde olduğu fakat orta kulaktaki adezyonlar nedeniyle protezin fikse olduğu görülmüştür. [41] Kos ve ark. [18] ise revizyon cerrahisinde elde ettikleri en sık bulguların fibröz doku nedeniyle protezin fiksasyonu ve inkus uzun kolunda erozyon olduğunu belirtmişlerdir.…”

“…Revizyonlarda eski protez çıkarılmalı ve yerine yenisi takılmalıdır, eski protez tekrar kullanıl-mamalıdır. [41] Bizim çalışmamızda hiçbir hastada adezyonlara bağlı fiksasyon izlenmemiştir. Bize göre bu komplikasyondan kaçınabilmek için dikkat edilmesi gereken en önemli nokta gereksiz mukoza hasarı yaratılmamasıdır.…”

Who should be a stapes surgeon? An otologist or a generalist?

“…In a recent review [18] of 63 revision stapes procedures, 52.4% cases resulted in an air-bone gap closure of less than 10 dB. Intraoperatively, the most common cause of failed primary surgery was malfunctioning prosthesis.…”