Revision stapedectomy

Abstract

The stapedectomy procedure has been in use since first introduced by John Shea, Jr. in 1956. Even though the results for primary surgery are quite good, the results for revision surgery do not carry as high a success rate. In addition, complications are more frequent for revision surgery. Otosclerosis is a common cause of progressive conductive hearing loss in young adults, which is more frequent in females than males and may be accelerated by pregnancy. The stapedectomy procedure has evolved from a total stapedectomy to a partial stapedectomy to a small fenestra stapedotomy. Various prostheses have been used over the years with uniformly high rates of success. The most common causes of failure in stapedectomy are displacement of the prosthesis from the oval window and erosion of the incus. Other reasons for failure are fixation of the malleus and incus, fistula or, rarely, displacement of the prosthesis into the vestibule. Before attempting revision surgery, the risks, complications, and alternatives must be thoroughly discussed with the patient. Many authors have described the use of the laser when performing the revision surgery. This seems to have reduced the complications, which were formally observed with revision surgery.