Revision stapedectomy

OBJECTIVE: To evaluate results of revision stapedectomy with and without use of the laser and determine factors predictive of hearing outcome. STUDY DESIGN AND SETTING: Retrospective review of 356 revision stapedectomy operations performed at the House Ear Clinic, a tertiary neurotologic private practice, between 1983 and 1995. RESULTS: A postoperative gap of less than or equal to 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 heating loss. A poorer outcome was related to incus necrosis, multiple revisions, and indications for surgery other than conductive hearing loss. CONCLUSION: Revision stapedectomy can provide good gap closure in 60% of cases, with small risk of sensorineural hearing loss. SIGNIFICANCE: Although not as satisfactory as primary stapedectomy, revision stapedectomy can be offered to patients with reasonable expectations for good gap closure.