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World J Otorhinolaryngol. Feb 28, 2015; 5(1): 21-29
Published online Feb 28, 2015. doi: 10.5319/wjo.v5.i1.21
Revision surgery for otosclerosis: An overview
Sertac Yetiser
Sertac Yetiser, Department of ORL and HNS, Anadolu Medical Center, Gebze, 41400 Kocaeli, Turkey
Author contributions: Yetiser S designed the study, analyzed the data and wrote the paper.
Conflict-of-interest: The author declares that he has no competing interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sertac Yetiser, MD, Professor, Department of ORL and HNS, Anadolu Medical Center, Cumhuriyet mahallesi, 2255 sokak No:3, Gebze, 41400 Kocaeli, Turkey. syetiser@yahoo.com
Telephone: +90-532-3248433 Fax: + 90-262-6540529
Received: September 15, 2014
Peer-review started: September 16, 2014
First decision: November 1, 2014
Revised: November 4, 2014
Accepted: December 3, 2014
Article in press: December 10, 2014
Published online: February 28, 2015
Processing time: 148 Days and 21.1 Hours
Abstract

Stapes surgery for otosclerosis has been proved to be a very satisfying procedure. However, the condition is difficult for the patients with no or little hearing gain after surgery and for those who had sudden or gradual hearing loss after a successful air-bone gap closure in the follow-up period. The issue of re-exploring the middle ear is challenging. A general review of this subject from several points of view remains lacking. In this study, articles related with the revision surgery for otosclerosis have been reviewed after a PubMed research and common and/or contradictory points were documented. The aim of this study is to give an insight to diagnostic and therapeutic approaches for the clinicians in patients who need a revision surgery. In conclusion, prosthesis problems, loose prosthesis in stapedotomy and migrated prosthesis in stapedectomy are the most common causes for revision surgery. Most important indicators which effect better hearing outcome following revision surgery are those ears with the presence of incus, with no obliteration of oval window, with small fenestra stapedotomy and the experience of surgeon. The risk of neurosensorial hearing loss in revision cases is not high but the hearing gain is limited as compared to primary cases. The rate of 10 dB air-bone gap closure is around 60%-70% at most and even less promising results have been reported. Patient’s demands and expectations have to be clarified in a realistic way.

Keywords: Otosclerosis; Stapedotomy; Stapedectomy; Revision

Core tip: It is very difficult for the patients with otosclerosis having no or little hearing gain after surgery and for those who had sudden or gradual hearing loss after a successful air-bone gap closure in the follow-up period. The issue of re-exploring the middle ear is challenging. A general review of this subject from several points of view remains lacking. In this study, articles related with revision surgery for otosclerosis have been reviewed after a PubMed research and common and/or contradictory points were documented.