REVISION STAPEDECTOMY FOR INCUS EROSION - LONG-TERM HEARING

One of the most common ossicular problems in revision stapedectomy is the eroded incus, Revision surgery has been reported as successful in 70% to 80% of cases at 1 year. Little is written about longterm result s or the association of erosion with various prostheses. We evaluated 83 cases from 1 to 20 years, including multiple revisions. In 23 cases the erosion was seen at initial stapedectomy Surgery was performed wi th the patient under local anesthesia, with the use of the Lippy modif ied prosthesis. Initial success was seen in 72% (41/57), satisfactory results in 90%, no change in 5%, and none worse. At 10 years, success had declined to 50% (7 of 14), with 80% satisfactory. The numbers for multiple revisions were lower. Success in nonrevision cases was 90% (2 1 of 23), dropping to 86% at 10 years, with satisfactory results in 10 0%, The type of prosthesis associated with erosion was a crimped wire in 34% (24 of 70), a plastic strut in 23%, and a Robinsion prosthesis in 17%, We conclude that the risk of incus erosion appears less with t he Robinson prosthesis. The Lippy modified prosthesis yields good long -term particularly when erosion is seen at initial stapedectomy, Resul ts worsen with subsequent revision.