The case against bilateral stapedectomy, and problems of post-operative follow-up— from the King' College Hospital series

Simultaneous bilateral stapes surgery – a pilot study

“…The most devastating complication can be severe SNHL that may occur years after the operation. Ludman and Grant reported 21 cases of severe or total SNHL in 1803 stapedectomies, and 3 of these arose more than 6 years after the operation [1]. Postoperative SNHL may occur due to perilymph fistulae, granuloma formation in the oval window, disturbance in inner ear fluid balance, aseptic or suppurative labyrinthitis, vascular disturbance or sudden release of enzymes into inner ear fluid [17].…”

“…Postoperative SNHL may occur due to perilymph fistulae, granuloma formation in the oval window, disturbance in inner ear fluid balance, aseptic or suppurative labyrinthitis, vascular disturbance or sudden release of enzymes into inner ear fluid [17]. Patients having revision surgery are exposed to a greater risk of SNHL [1]. Recent studies have shown that neither operative methods nor bilateral operation contributes significantly to SNHL.…”

“…In bilateral disease, the expediency of operating on the second ear has been controversial. Some authors argue against second ear operation because of the risk of sensorineural hearing loss (SNHL) that can occur, even years after the operation [1,2]. Vestibular damage may also occur and, at worst, it could also be bilateral leading to a significant disability [3].…”

Microcomputers in Clinical Research: Discussion Paper

“…The examination of stapedectomy results by this method (Ludman & Grant 1973) proved very cumbersome in comparison with any microcomputerbased method. In 1979 my first microcomputer system was acquired at a time when conditions were different-from today.…”

Indication for Surgery in Otosclerotic Patients With Unilateral Hearing Loss

“…There is a general agreement regarding the indication to surgery as an elective treatment for bilateral otosclerosis, whereas the indication for surgical option in unilateral otosclerosis has been debated, and similarly, different papers are in favor (2,3) or against (4,5) the policy of performing a second stapes operation for bilateral otosclerosis. In fact, many surgeons think that in such cases, the patients should be allowed to wear hearing aid in the second ear if necessary (6).…”