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Updated: Nov 18, 2025

The Microscopic Transcanal Approach in Stapes Surgery Revisited
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Outcomes in Revision Stapes Surgery.

Zachary G Schwam1, Amy Schettino2, Seilesh C Babu3

  • 1Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Health System, New York, New York, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|February 9, 2021
PubMed
Summary

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Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·2025

Revision stapes surgery yields poorer hearing outcomes and higher complication rates compared to primary stapes surgery. These findings highlight the challenges associated with revision procedures in otologic surgery.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Audiology

Background:

  • Stapes surgery is a common procedure for hearing restoration.
  • Revision stapes surgery is performed when primary surgery fails or complications arise.
  • Understanding outcomes of revision surgery is crucial for patient counseling and surgical planning.

Purpose of the Study:

  • To compare audiometric results and complication rates between primary and revision stapes surgery.
  • To evaluate the effectiveness of revision stapes surgery in achieving hearing improvement.
  • To identify risk factors for poorer outcomes in revision stapes surgery.

Main Methods:

  • Retrospective cohort study analyzing data from a large single-institution database.
  • Inclusion of 809 patients undergoing primary (n=639) and revision (n=170) stapes surgery.
Keywords:
revision stapedectomyrevision stapedotomyrevision surgerystapedectomystapedotomy

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  • Statistical analysis included Pearson chi-square and multivariable logistic regression.

    • Main Results:

    • Revision cases showed significantly worse postoperative air-bone gap (ABG) closure to ≤10 dB (40.2% vs 61.8%) and ≤20 dB (78.1% vs 90.9%).
    • Bone conduction worsened by >10 dB in 13.1% of revisions versus 7.1% of primary cases.
    • Higher rates of reparative granuloma and hydrops were observed in revision cases (2.4% vs 0.2% and 1.8% vs 0.2%, respectively).

    Conclusions:

    • Revision stapes surgery is associated with less predictable and inferior audiometric outcomes compared to primary stapes surgery.
    • Increased complication rates, including reparative granuloma and hydrops, are noted in revision cases.
    • These findings underscore the importance of careful patient selection and surgical technique in revision stapes procedures.