[Revision surgery of otosclerosis: a review of 26 cases].
OBJECTIVE
The aim of this study was to identify causes of primary stapedectomy failures and to evaluate hearing results in revision stapes surgery.


METHODS
We retrospectively reviewed a series of 26 revision stapedectomies. Patient characteristics, preoperative findings, causes of failure and complication of primary stapedectomy and postoperative hearing results were noted.


RESULTS
Conductive hearing loss was the most common reason for revision surgery (77 %). Leading causes of stapedectomy failure included prosthesis malfunction (42 %), fibrous adhesions (37,5 %), incus erosion (12,5 %) and otosclerotic regrowth (12,5 %). When revision was indicated because of cochleo-vestibular complication, middle ear exploration revealed 3 problems: oval window granuloma or excessively long prosthesis or perilymphatic fistula. In this series, postoperative air-bone gap was closed to less than 10 dB in 57 % of cases, to less than 20 dB in 71 % of cases and we did not observed any sensorineural hearing loss.


CONCLUSIONS
The results of this series are comparable with previously published studies. Revision stapes surgery is not as successful as primary stapedectomy, but the risk of sensorineural hearing loss does not appear to be higher than in primary surgery. Revision surgery is a challenging problem that must be performed by an experienced surgeon.
Ayache
D
D
Service ORL, Fondation Adolphe de Rothschild, 25-29 rue Manin, 75019 Paris. dayache@fo-rothschild.fr
El Kihel
M
M
Betsch
C
C
Bou Malhab
F
F
Elbaz
P
P
D000328:Adult; D000368:Aged; D001299:Audiometry; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019933:Ossicular Replacement / Q000295:instrumentation; D010040:Otosclerosis / Q000150:complications / Q000601:surgery*; D018579:Patient Selection; D011475:Prosthesis Failure; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D013201:Stapes Surgery / Q000295:instrumentation / Q000379:methods*; D017211:Treatment Failure