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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2022; 26(03): e422-e427
DOI: 10.1055/s-0041-1740100
Original Research

Revision Stapedotomies: The Role of Periprosthetic Scar Tissue Formation in the Development of Unsatisfactory Hearing Results after Stapedotomy

Autoren

  • Gábor Polony 

    1   Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis Egyetem (Semmelweis University), Budapest, Hungary

  • Anita Gáborján 

    1   Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis Egyetem (Semmelweis University), Budapest, Hungary

  • László Tamás

    1   Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis Egyetem (Semmelweis University), Budapest, Hungary

  • László Székely 

    1   Department of Otorhinolaryngology, Head and Neck Surgery, Semmelweis Egyetem (Semmelweis University), Budapest, Hungary
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Abstract

Introduction Revision stapes surgeries are difficult to perform, and their audiological results are inferior to primary surgeries.

Objective Our goal was to identify the most common and most influential postoperative reasons that cause persistent air-bone gap (ABG) after the primary surgery. Our focus was concentrated on the mechanical dysfunctions in the middle ear, with special regard to postoperative adhesion formation.

Methods We performed a retrospective case series study with 23 cases that underwent revision stapedotomies.

Results A significant improvement was seen in ABG and air conduction levels after surgery. The periprosthetic adhesion formation was seen in 65% of the cases, and it was the primary cause behind the unsatisfactory hearing result in 30% of cases. There was no significant difference in the level of persistent ABGs after the primary surgery, in case of the intratympanic adhesion presence, compared with the presence of other surgical failures. Concerning hearing and ABG gain after revision surgery, the non-inferiority of the negative effect associated with adhesion was shown compared with the other reasons.

Conclusion The revision stapedotomy is an efficient treatment option in case of persistent ABG. Periprosthetic adhesions are the most common intratympanic reasons for compromised audiological outcomes after stapedotomy.

Adhesion formations have the same negative effect on ABG development as any other surgical failure, and the revision could be more challenging in these cases. These findings highlight the use of the most atraumatic surgical technique and preservation of intact intratympanic mucosa during middle ear surgery.

Keywords

otosclerosis - stapes - stapedotomy - otologic surgical techniques - middle ear

Ethical Approval

The present research was approved by Semmelweis University, Budapest, Hungary. For this type of study, formal consent is not required.


Semmelweis University Regional and Institutional Committee of Science and Research Ethics (SE RKEB 159/2019.)




Publikationsverlauf

Eingereicht: 30. November 2020

Angenommen: 02. September 2021

Artikel online veröffentlicht:
13. Dezember 2021

© 2021. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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