Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-18T14:41:27.131Z Has data issue: false hasContentIssue false
  • English
  • Français

Persistent and recurrent conductive deafness following stapedotomy

Published online by Cambridge University Press:  09 December 2010

G Thiel  and
R Mills
G Thiel*
Affiliation:
Otolaryngology Unit, University of Edinburgh, Scotland, UK
R Mills
Affiliation:
Otolaryngology Unit, University of Edinburgh, Scotland, UK
*
Address for correspondence: Dr Gundula Thiel, Otolaryngology Unit, Lauriston Building, Lauriston Place, Edinburgh EH3 9EN, Scotland, UK Fax: +44 (0)131 536 3744 E-mail: gundulathiel@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Stapedotomy produces the best hearing results of any otological operation. However, in a small number of cases the air–bone gap is not successfully closed, or conductive hearing loss recurs.

Objective:

To investigate the proportion of cases in the senior author's series which required revision surgery and to determine the medium to long term success rate of surgery, taking into account the results of revision surgery.

Methods:

Review of a series of 233 primary stapedotomy operations and 100 revision procedures carried out by one surgeon over a 20-year period.

Results:

Closure of the air–bone gap to within 10 dB was achieved in 80 per cent of cases following the primary procedure. Fifteen per cent of patients developed a recurrence of conductive hearing loss. When the results of revision surgery were taken into account, the proportion of ears with a mean air–bone gap of less than 10 dB was 86 per cent. However, of the patients undergoing revision surgery, air–bone gap closure to within 10 dB was only achieved in 52 per cent of cases.

Conclusion:

The best chance of obtaining a successful outcome in stapedotomy is to achieve this for the first procedure. However, revision surgery does increase the medium to long term success rate.

Keywords

OtosclerosisStapedectomy and Surgical RevisionOtologic Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 5 , May 2011 , pp. 460 - 466
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Meyer, TA, Lambert, PR. Primary and revision stapedectomy in elderly patients. Curr Opin Otolaryngol Head Neck Surg 2004;12:387–92Google ScholarPubMed
2Battista, RA, Wiet, RJ, Joy, J. Revision stapedectomy. Otolaryngol Clin North Am 2006;39:677–97CrossRefGoogle ScholarPubMed
3Lippy, WH, Wingate, J, Burkey, JM, Rizer, FM, Schuring, AG. Stapedectomy revision in elderly patients. Laryngoscope 2002;112:1100–3CrossRefGoogle ScholarPubMed
4Lippy, WH, Battista, RA, Berenholz, L, Schuring, AG, Burkey, JM. Twenty-year review of revision stapedectomy. Otol Neurotol 2003;24:560–6CrossRefGoogle ScholarPubMed
5Lippy, WH, Schuring, AG, Zargi, M. Stapedectomy revision. Am J Otol 1980;15:383–8Google Scholar
6Crabtree, JA, Britton, BH, Powers, WH. An evaluation of revision stapes surgery. Laryngoscope 1980;90:224–7CrossRefGoogle ScholarPubMed
7Sheehy, JL, Nelson, RA, House, HP. Revision stapedectomy: a review of 258 cases. Laryngoscope 1981;91:43–51CrossRefGoogle ScholarPubMed
8Pearman, K, Dawes, JD. Post-stapedectomy conductive deafness and results of revision surgery. J Laryngol Otol 1982;96:405–10CrossRefGoogle ScholarPubMed
9Lindeman, RC, Mangham, CA, Neal, GD. Revision of polythene strut stapedectomy. Trans Pac Coast Oto-Ophthalmol Soc 1982;63:125–31Google Scholar
10Derlacki, EL. Revision stapes surgery: problems with some solutions. Laryngoscope 1985;95:1047–53CrossRefGoogle ScholarPubMed
11Glasscock, ME, McKennan, KX, Levine, SC. Revision stapedectomy surgery. Otolaryngol Head Neck Surg 1987;96:141–8CrossRefGoogle ScholarPubMed
12Lesinski, SG, Palmer, A. Lasers for otosclerosis: CO2 vs. argon and KTP-532. Laryngoscope 1989;99:1–8Google ScholarPubMed
13Farrior, J, Sutherland, A. Revision stapes surgery. Laryngoscope 1991;101:1155–61CrossRefGoogle ScholarPubMed
14Vartiainen, E, Nuutinen, J, Virtaniemi, J. Long-term results of revision stapes surgery. J Laryngol Otol 1992;106:971–3CrossRefGoogle ScholarPubMed
15Langman, AW, Lindeman, RC. Revision stapedectomy. Laryngoscope 1993;103:954–8CrossRefGoogle ScholarPubMed
16Horn, KL, Gherini, SG, Franz, DC. Argon laser revision stapedectomy. Am J Otol 1994;15:383–8Google ScholarPubMed
17Silverstein, H, Bendet, E, Rosenberg, S, Nichols, M. Revision stapes surgery with and without laser: a comparison. Laryngoscope 1994;104:1431–8CrossRefGoogle ScholarPubMed
18Han, WW, Incesulu, A, McKenna, MJ, Rauch, SD, Nadol, JB Jr, Glynn, RJ. Revision stapedectomy: intraoperative findings, results, and review of the literature. Laryngoscope 1997;107:1185–92CrossRefGoogle ScholarPubMed
19Magliulo, G, Cristofari, P, Terranova, G. Functional hearing results in revision stapes surgery. Am J Otol 1997;18:408–12Google ScholarPubMed
20Shea, JJ Jr. Forty years of stapes surgery. Am J Otol 1998;19:52–5Google ScholarPubMed
21Hammerschlag, PE, Fishman, A, Scheer, AA. A review of 308 cases of revision stapedectomy. Laryngoscope 1998;108:1794–800CrossRefGoogle ScholarPubMed
22De La Cruz, A, Fayad, JN. Revision stapedectomy. Otolaryngol Head Neck Surg 2000;123:728–32CrossRefGoogle ScholarPubMed
23Gros, A, Vatovec, J, Zargi, M, Jenko, K. Success rate in revision stapes surgery for otosclerosis. Otol Neurotol 2005;26:1143–8CrossRefGoogle ScholarPubMed
24Puxeddu, R, Ledda, GP, Pelagatti, CL, Salis, G, Agus, G, Puxeddu, P. Revision stapes surgery for recurrent transmissional hearing loss after stapedectomy and stapedotomy for otosclerosis. Acta Otorhinolaryngol Ital 2005;25:347–52Google ScholarPubMed
25Bhardwaj, BK, Kacker, SK. Revision stapes surgery. J Laryngol Otol 1988;102:20–4CrossRefGoogle ScholarPubMed
26Krieger, LW, Lippy, WH, Schuring, AG, Rizer, FM. Revision stapedectomy for incus erosion: long-term hearing. Otolaryngol Head Neck Surg 1998;119:370–3CrossRefGoogle ScholarPubMed
27Lesinski, SG. Causes of conductive hearing loss after stapedectomy or stapedotomy: a prospective study of 279 consecutive surgical revisions. Otol Neurotol 2002;23:281–8CrossRefGoogle ScholarPubMed
28Pedersen, CB. Revision surgery in otosclerosis – operative findings in 186 patients. Clin Otolaryngol 1994;19:446–50CrossRefGoogle ScholarPubMed
29Berenholz, L, Lippy, W, Harell, M. Revision stapedectomy in Israel. Otol Neurotol 2002;23:850–3CrossRefGoogle ScholarPubMed
30Szymanski, M, Mills, R, Abel, E. Transmission of heat to the vestibule during revision stapes surgery using a KTP laser: an in vitro study. J Laryngol Otol 2003;117:349–52CrossRefGoogle Scholar
31Pedersen, CB. Revision surgery in otosclerosis – an investigation of the factors which influence the hearing result. Clin Otolaryngol 1996;21:385–8CrossRefGoogle ScholarPubMed