HOW I DO PRIMARY AND REVISION STAPEDECTOMY

Localized anterior otosclerosis is found in about 80 percent of primar y stapedectomy operations. For these patients, partial stapedectomy wi th vein graft is recommended. Obliterative otosclerosis is the patholo gy found in the remaining 20 percent of primary stapedectomy operation s. In these cases, stapedotomy with lining membrane of the middle ear or vein graft is the procedure of choice. Revision stapedectomy may im prove conductive hearing loss caused by (1) migration and/or dislocati on of the prosthesis, (2) eversion of the lining membrane of the vesti bule with resulting dislocation of the prosthesis and possible erosion of the lower incus, (3) bony closure of the oval window, or (4) epity mpanic fixation of the incus and/or malleus. Successful operative tech niques used in primary and revision stapedectomy are described.