Revision stapes surgery: retrospective analysis of surgical findings in a series of 21 otosclerosis patients.

摘要

AIM: Retrospective analysis of surgical findings in revision stapes surgery in a group of 21 otosclerosis patients qualified for the secondary procedure at the Otosurgery Department of the Medical University of Lodz, Poland, from 1980 to 2002. MATERIALS AND METHODS: 21 cases of revision stapes surgery out of a total of 350 surgically treated otosclerosis cases are discussed. Group A consisted of 17 cases of revision surgery out of 274 patients who had undergone total stapedectomy (1980-1995) and group B consisted of 4 cases out of 76 patients after stapedotomy (1996-2002). RESULTS: In group A, 17 patients underwent revision surgery, corresponding to 6.2% out of 274 total stapedectomy cases. Among the indications for the secondary surgical procedure in this group of patients were: (a) platinum wire prosthesis displacement with ossicular chain discontinuity (n = 12); (b) perichondrium or adipose tissue atrophy (n = 3), and (c) incudostapedial joint luxation (n = 2). Group B was composed of 4 cases, i.e. 5.3% out of 76 stapedotomy patients (Teflon piston operation, 0.6 mm). For both groups, the mean percentage of revision cases was 6% of all patients operated for otosclerosis. Time from the initial surgical procedure to reoperation varied from 1 to 8 years. CONCLUSIONS: (1) The most common indication for revision stapes surgery in patients after total stapedectomy was prosthesis displacement and necrosis of the long crus of the incus. (2) Obliteration of the stapes footplate after small fenestra operation was observed to be the most frequent indication for the secondary stapes procedure in our patient groups.