title: Revision stapedectomy with bone cement: are results comparable to those of standard techniques?
abstract: OBJECTIVE
  To examine hearing results in revision stapedectomy using hydroxyapatite bone cement for incus necrosis.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Tertiary care academic medical center.
  
  
  METHODS
  Eligible patients underwent revision stapedectomy for otosclerosis using hydroxyapatite bone cement to reconstruct incus necrosis between March 2007 and August 2013. Patients were excluded for insufficient audiometric data or an operative indication other than otosclerosis.
  
  
  METHODS
  Revision stapedectomy performed with standard stapes piston prostheses using hydroxyapatite bone cement to stabilize the prosthesis.
  
  
  METHODS
  Air-bone gap (ABG), air-conduction and bone conduction pure-tone audiometry thresholds, and speech discrimination scores (SDSs) were obtained preoperatively and postoperatively. The preoperative result closest to the date of surgery was compared with the postoperative result farthest from the date of surgery.
  
  
  RESULTS
  Twenty-seven patients (aged 32-83 yr) met criteria and were included in the study. Average duration of follow-up was 7 months (range, 1-39 mo). Postoperative closure of the ABG to within 10 dB was achieved in 77.8% of cases. Closure to within 20 dB was achieved in 96.3%. The average postoperative ABG was 8.1 dB (range, 0-24 dB). The average SDS change was +7.4% (-12% to +92%). There were no cases of significant postoperative sensorineural hearing loss by bone conduction pure-tone audiometry.
  
  
  CONCLUSIONS
  Use of hydroxyapatite cement for treatment of incus necrosis in revision stapedectomy provides excellent hearing outcomes and is a reasonable alternative to total ossicular reconstruction prosthesis or malleovestibular prosthesis techniques.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, Utah, U.S.A.
authors.forename: Scott K
authors.initials: SK
authors.lastname: Hudson
authors.forename: Richard K
authors.initials: RK
authors.lastname: Gurgel
authors.forename: Clough
authors.initials: C
authors.lastname: Shelton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006882:Hydroxyapatites / Q000627:therapeutic use*; D007188:Incus / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000379:methods*
chemical_list: D001843:Bone Cements; D006882:Hydroxyapatites; C475044:hydroxyapatite cement