Revision stapedectomy.

Abstract

To evaluate results of revision stapedectomy with and without use of the laser and determine factors predictive of hearing outcome. Retrospective review of 356 revision stapedectomy operations performed at the House Ear Clinic, a tertiary neurotologic private practice, between 1983 and 1995. A postoperative gap of < or =10 dB was obtained in 60% of cases. Results were similar with and without the use of a laser. Sensorineural hearing loss of >10 dB occurred in 7.7%, with 3 (1.4%) ears with profound hearing loss. A poorer outcome was related to incus necrosis, multiple revisions, and indications for surgery other than conductive hearing loss. Revision stapedectomy can provide good gap closure in 60% of cases, with small risk of sensorineural hearing loss. Although not as satisfactory as primary stapedectomy, revision stapedectomy can be offered to patients with reasonable expectations for good gap closure.