Outcomes in Revision Stapes Surgery.

Abstract

To compare audiometric outcomes and complication rates between primary and revision stapes surgical cases. Retrospective cohort study. Large single-institution database. Data on 809 patients (including 170 revisions) undergoing primary and revision stapes surgery were reviewed, with Pearson chi-square and multivariable logistic regression analysis performed. Rates of postoperative air-bone gap (ABG) closure to ≤10 dB were significantly worse in the revision group (40.2% vs 61.8%, <i>P</i> < .001), as were those to ≤20 dB (78.1% vs 90.9%, <i>P</i> < .001). The bone conduction pure tone average worsened by >10 dB in 7.1% of primary cases and 13.1% of revisions (<i>P</i> = .016). The mean postoperative ABG for revision cases was significantly higher at 15.5 dB as compared with 11.0 dB for primaries (<i>P</i> < .001), despite a slightly higher preoperative ABG for primary cases (30.6 vs 28.24 dB, <i>P</i> = .010). In multivariate analysis, revision surgery had an odds ratio 0.41 (<i>P</i> < .001) in closing the ABG to ≤10 dB. Postoperative reparative granuloma (2.4% vs 0.2%, <i>P</i> = .001) and hydrops (1.8% vs 0.2%, <i>P</i> = .008) were higher in revision cases. Revision stapes surgery was found to have less predictable and inferior results as compared with primary cases. 4 (retrospective observational research).