title: Reparative granuloma seen in cases of gold piston implantation after stapes surgery for otosclerosis.
abstract: OBJECTIVE
  to determine the occurrence of the unusual side effect of a reparative granuloma after the implantation of a pure gold piston in cases of otosclerosis.
  
  
  METHODS
  a retrospective case review study of 475 stapes operations with a pure gold piston.
  
  
  METHODS
  Department of Otorhinolaryngology of the University of Amsterdam, The Netherlands and the HNO clinic in Luenen (Brambauer) in Germany.
  
  
  METHODS
  four hundred and seventy five patients (328 women, 147 men, average age: 45.2 years), who clinically and per-operatively had otosclerosis, underwent a stapedotomy using a pure gold piston prosthesis. Therapeutic intervention: in cases of suspicion of a reparative granulomas or those cases that did not have improvement of the hearing after the stapedotomy, a re-operation by transcanal approach was performed.
  
  
  RESULTS
  in seven cases a reparative granuloma was diagnosed by this revision surgery. The postoperative incidence of these granulomas following stapedotomy using the pure gold piston turned out to be 1.5%.
  
  
  CONCLUSIONS
  reparative granulomas can occur after stapedotomy with a pure gold stapes piston although the incidence is low. The role of grafting material to seal the oval window niche and the treatment of these reparative granulomas following stapes surgery are discussed.
authors.affiliation: Department of Otorhinolaryngology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. r.a.tange@amc.uva.nl
authors.forename: Rinze A
authors.initials: RA
authors.lastname: Tange
authors.forename: Goesta
authors.initials: G
authors.lastname: Schimanski
authors.forename: Jeroen W L
authors.initials: JW
authors.lastname: van Lange
authors.forename: Wilko
authors.initials: W
authors.lastname: Grolman
authors.forename: Lot C
authors.initials: LC
authors.lastname: Zuur
mesh_terms: D004427:Ear Diseases / Q000473:pathology* / Q000601:surgery; D005260:Female; D006099:Granuloma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000473:pathology* / Q000601:surgery*; D011184:Postoperative Period; D019736:Prostheses and Implants; D012189:Retrospective Studies; D013201:Stapes Surgery