POSTOPERATIVE RESULTS IN REVISION STAPES SURGERY

Background: In this retrospective study indications, intraoperative fi ndings, reconstruction techniques and postoperative hearing results in revision stapes surgery were evaluated. Patients: Between March 1988 and January 1996, 150 patients underwent stapes revision. Indications for surgery were the presence of conductive hearing loss (132), dizzin ess (12), sensorineural hearing loss (3), deafness (2), and tinnitus ( 1). Results: Intraoperative findings were lateral migration of the imp lant, regrowth of bone in the oval window niche, erosion of incus, cho lesteatoma, and others. In most cases a new prosthesis (gold piston) w as inserted between incus and vestibulum. In cases with incus erosion, a malleovestibulopexy was performed. Seventy-three percent of patient s who underwent revision stapes surgery because of conductive hearing loss showed a hearing improvement of 20 dB or more. All patients who u nderwent revision stapes surgery because of dizziness reported an impr ovement of their symptoms postoperatively. Conclusions: Revision stape s surgery should be approached by experienced surgeons, because the ri sk of severe sensorineural hearing loss is higher than at the time of primary stapedectomy. Informed consent is mandatory.