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Revision stapes surgery: the malleus to oval window wire-piston technique
Darius Kohan1, Alexander Sorin
1Department of Otolaryngology, New York University, School of Medicine, New York, New York, USA. earmavin@aol.com
Objective:
To determine the effectiveness of the malleus to oval window wire-piston revision stapes surgery technique.
Study Design:
A retrospective analysis of 243 stapes procedures performed by the senior author over a 10-year period identified 15 revisions. Five patients underwent a malleus to oval window wire-piston technique. All patients were followed for at least 6 months. The surgical outcome including audiologic data and complications are noted.
Methods:
Stapes surgery was performed on an ambulatory basis by way of a transcanal approach under local anesthesia with monitored sedation by the same surgeon using a laser technique and a stapes wire-piston prosthesis.
Results:
Among revision stapes procedures, there was no significant difference in the air-bone gap closure or complication rate between the incus to oval window and the malleus to oval window techniques. The average preoperative air-bone gap in all revisions was 32 dB, whereas the mean postoperative gap was 10 dB hearing loss.
Conclusions:
In experienced hands, revision stapes surgery using the malleus to oval window stapes wire-piston prosthesis is safe and effective.