title: Twenty-year review of revision stapedectomy.
abstract: OBJECTIVE
  To evaluate surgical findings and techniques, patient management techniques, and audiometric results of 522 revision stapedectomies.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary otologic referral center.
  
  
  METHODS
  A total of 522 revision stapedectomies over a 20-year period in Warren, Ohio, and Israel. The audiologic criterion for revision was an air-bone gap greater than 20 dB over the three-frequency range 0.5 to 2 kHz.
  
  
  RESULTS
  Of the 522 revision cases, a total of 483 patients were operated on to improve hearing. The remainder of the patients were operated on for various other noted reasons. Closure of the air-bone gap to within 10 dB was achieved in 71% of patients (343 of 483). The mean pure-tone average improvement was 17.8 dB, with an average postoperative air-bone gap of 7.3 dB. The most common surgical findings were prosthesis malfunction at the oval window, incus, or both (58%). Since beginning the use of the Argon laser for surgical problems, the success rate has increased to 80%. A subgroup of 35 Argon laser revision stapedectomies resulted in a larger hearing gain (25.2 dB) and 91.4% closure of the air-bone gap to less than 10 dB.
  
  
  CONCLUSIONS
  More than 70% of revision stapedectomy cases for hearing improvement have had successful closure of their air-bone gap. Since the introduction of the laser 5 years ago, the success rate has increased to 80%. In those specific cases where the laser was required, the success rate increased to 91.4%. Regardless of the revision technique, hearing results were the least successful when the incus could not be used for reconstruction.
authors.affiliation: Lippy Group for Ear, Nose and Throat, Warren, Ohio 44484, USA. whlmd@aol.com
authors.forename: William H
authors.initials: WH
authors.lastname: Lippy
authors.forename: Robert A
authors.initials: RA
authors.lastname: Battista
authors.forename: Leonard
authors.initials: L
authors.lastname: Berenholz
authors.forename: Arnold G
authors.initials: AG
authors.lastname: Schuring
authors.forename: John M
authors.initials: JM
authors.lastname: Burkey
mesh_terms: D000818:Animals; D004867:Equipment Design; D005276:Fenestration, Labyrinth / Q000009:adverse effects; D020342:Finite Element Analysis; D006309:Hearing; D006801:Humans; D008962:Models, Theoretical; D009998:Ossicular Prosthesis / Q000009:adverse effects; D012086:Reoperation; D012189:Retrospective Studies; D013201:Stapes Surgery