Authors: Vincent Pitiot Ruben Hermann Stéphane Tringali Christian Dubreuil Eric Truy
Publish Date: 2015/12/21
Volume: 273, Issue: 9, Pages: 2515-2521
Abstract
The objective of the study was to report audiological results in revision stapes surgery comparing hydroxyapatite HAP bone cement malleovestibular MV prosthesis and total ossicular replacement prosthesis TORP The study is a retrospective case review conducted in a tertiary referral center Patients treated for revision stapes surgery from 2010 to 2014 where a lysis of the long process of the incus LPI was observed with the use of HAP bone cement MV prosthesis or a TORP were included in the study The main outcomes measured were pre and postoperative bone conduction BC and air conduction AC puretone averages PTA 05 1 2 3 kHz including high frequencies BC HFBC 1 2 3 4 kHz and air–bone gap ABG 107 revision stapes surgery were performed in 96 ears Main cause of failure was LPI lysis in 38 cases 396 31 patients were analyzed HAP bone cement was used in 11 patients Group I MV prosthesis in ten patients Group II and TORP in ten patients Group III The mean postoperative ABG was 107 dB ±74 p = 0003 107 dB ±88 p = 0001 and 169 dB ±98 p = 0001 respectively There were no significant differences between groups In Group I the mean change in HFBC revealed an improvement of 56 dB ±79 p = 003 while in Group III there was a significant deterioration of the thresholds of 58 dB ±76 p = 004 There were no cases of postoperative anacusis In revision stapes surgery when LPI is eroded we recommend to perform a cement ossiculoplasty for stabilizing a standard Teflon piston when LPI is still usable the LPI lengthening with cement being not recommended When LPI is too eroded we prefer performing a malleovestibulopexy and reserve TORP for cases with a bad anatomical presentation
Keywords: