RESULTS OF REVISION STAPEDECTOMY FOR CONDUCTIVE HEARING-LOSS

Revision stapedectomy operations performed over a 13-year period (1977 to 1990) for a conductive hearing loss are reviewed in terms of intra operative findings and hearing results. All operations were performed in a conventional manner without use of laser techniques. A management algorithm based on intraoperative findings is described. Results are compared with previously reported series. The 66 cases include 20 male s and 46 females, ranging in age from 8 to 73 years. Mean time between original and revision stapedectomy was 12.5 years. Prostheses encount ered at time of revision included wireloop (29), Robinson (18), polyet hylene (14), other (3), and two were not found. The most common cause of failure was displacement of the prosthesis. Incus erosion was found in 48% of wireloops, 35% of polyethylene, and only 11% of the Robinso n prostheses. Revision resulted in closure of the pure-tone average (P TA) air-bone gap to within 10 dB in 46% and to within 15 dB in 76%. Se nsorineural hearing loss (> 10 dB) occurred in 5 cases (7.6%), and a d ecline in speech discrimination (> 10%) occurred in 17%. Three of four cases requiring drillout had gap closure to within 10 dB. Findings su ggest that our management technique produces results comparable to oth er large reported series. Drillout at the time of revision can be reco mmended.