Revision stapedectomy in Israel

Objective: To evaluate the audiometric results and surgical findings of revision stapedectomy in Israel. Study Design: Retrospective. Setting: Tertiary referral center and private otology practice. Patients: Seventy-eight patients over 13 years. Results: A total of 78 patients were evaluated during a mean follow-up time of 1.5 years. Ten patients with far advanced otosclerosis or dizziness were then excluded. Closure of airbone gap to within 10 dB was achieved in 67.6% of patients. Pure tone average (PTA, 500-1,000 Hz) improvement in hearing was 22.5 dB. Operative findings at time of revision were prosthesis malfunction (42.6%), incus necrosis (22%), incomplete stapedectomy (11.8%), and fistula (1.5%). Sensorineural hearing loss occurred in one patient. The technique of revision involved regrafting the oval window and the use of a piston prosthesis. Conclusions: The surgical findings and results in this study are similar to those in other large studies. Although success was less than in primary stapedectomy, the results justified revisions. Hearing gains were dependent on surgical findings, the number of previous revisions, and associated ossicular problems.