Persistent and recurrent conductive deafness following stapedotomy

Thiel, Gundula; Mills, R

doi:10.1017/s0022215110002422

Cited by 9 publications

(15 citation statements)

References 23 publications

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“…Comparable to the findings described in the literature, 2 , 12 stapedotomy was associated with better results, in that this technique was performed in most of the patients requiring only a single surgical intervention. The hearing results presented in this study are similar to those of previous studies 3 , 6 , 9 demonstrating reduced hearing outcomes following revision surgery.…”

Section: Discussionsupporting

confidence: 50%

“…Various other causes of prosthesis failure do exist and have been described in the literature. 2 , 3 , 5 , 6 Factors such as incus erosion or prosthesis malfunction itself, which can contribute to primary procedure failure, have been excluded from our study and thus are thought not to be contributing factors in the results demonstrated here. The retrospective nature of this study, however, does include certain limitations.…”

Section: Discussionmentioning

confidence: 92%

“…It is well recognized that overall hearing results following a revision stapes surgery are inferior to those obtained after a primary procedure. 4 – 6 The rate of success of revision surgery has been described to range from 16% to 80% of cases, 2 , 7 carrying an increased risk of sensorineural hearing loss (SNHL) postoperatively in up to 20% of cases. 5 , 6 , 8 , 9 Additionally, the possibility of hearing improvement evaluated by hearing gain has been reported to decrease by 10% for each revision performed on the same patient.…”

Section: Introductionmentioning

confidence: 99%

“…The most common indications for revision stapes surgery, as identified in the current literature, include prosthesis malfunction, dislocation or displacement, inaccurate prosthesis length (either too long or short), eroded incus, fibrous adhesions, or refixation of the footplate. 2 , 3 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

“…Several studies in the literature have evaluated the effect of stapedectomy versus stapedotomy as well as prosthesis diameter in hearing outcomes following successful otosclerosis surgery. 2 , 11 , 12 Studies describing the effect of prosthesis length, however, are limited.…”

Section: Introductionmentioning

confidence: 99%

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The Relationship between Stapes Prosthesis Length and Rate of Stapedectomy Success

Marchica

Saliba

2015

Clin Med Insights Ear Nose Throat

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OBJECTIVESTo identify whether measurement of the prosthesis length is mandatory in patients requiring otosclerosis surgeries and to assess their postoperative audiometric outcomes. In addition, evaluation of prosthesis length used in revision compared to primary stapedectomy was carried out.STUDY DESIGNCase series with chart review.METHODSChart review of 393 patients undergoing primary (321) versus revision stapedectomy (72) was performed in a tertiary referral center. The indication for surgery was the presence or persistence/recurrence of an air-bone gap (ABG) greater than 20 dB. Air and bone conduction thresholds (ACT and BCT, respectively), ABG as well as pure tone averages (PTAs) were determined for all patients, and the results were compared preoperatively and postoperatively.RESULTSProsthesis length used ranged from 3.0 to 6.0 mm without differences between primary and revision groups. Of the revision surgeries, 62.5% were stapedectomies versus stapedotomies (P < 0.001). Patients showed significant decrease in speech discrimination score, with increased air and bone conduction thresholds as well as mean ABG and PTA before the revision surgeries as a first procedure failure. Prosthesis length changes occurred in 73.5% of the cases, with an average absolute change of 0.55 mm. Prosthesis length did not affect postoperative audiometric results between primary and revision groups, in all surgeries combined. When grouping stapes surgery into accurately versus inaccurately measured incus-footplate distance, significant differences were observed in prosthesis length employed (P < 0.01). Hearing outcomes were also better in the group in which an accurately measured prosthesis was chosen, as opposed to “standard-length” prosthesis.CONCLUSIONSThis study corroborates postoperative success rates of revision surgeries, which show smaller improvements in hearing compared to a primary intervention. Accurate intra-operative measurement of prosthesis length was correlated with better audiometric results postoperatively.

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