Revision stapedectomy

The aim of the study was to determine the causes of failure in otosclerosis surgery. We performed 23 revisions of stapedectomy during the period between January 2000 and April 2005. The time between the primary surgery and the revision surgery ranged from 3 months to 25 years. The most frequent reasons for revision surgery were first of all patients with closed initial gap and progressive hearing loss in 56.52 % of cases and secondly patients without any initial hearing improvement in 39.12 % of cases. The main surgical findings were: short prosthesis in correct position (13.04 %), displaced prosthesis (60.87 %), bridles over the oval window (65.22 %), necrosis of the long process of the incus (26.2 %), and obliterative footplate (26.09 %). As for the audiometric results, we got a complete closure of gap in 60.8 % of patients (n = 14), partial closure of gap in 13.2 % (n = 3), persistence of the initial gap in 21.7 % (n = 5), and cophosis in 4.3 % (n = 1). The migration of the prosthesis is the main cause of failure after stapedectomy. Good closure of the gap was achieved in two thirds of the patients.