Surgical Management of Stapedo-Vestibular Reparative Granuloma Following Otosclerosis Surgery: A STROBE Retrospective...

ImportanceReparative granuloma (RG) is a rare but severe complication of otosclerosis surgery, presenting with vertigo, tinnitus, and hearing loss. Surgical intervention may offer effective symptom relief.ObjectiveTo evaluate the effectiveness of surgical management for RG following otosclerosis surgery in alleviating vestibular symptoms and preserving hearing.DesignRetrospective cohort study (STROBE guidelines).SettingTertiary referral center.ParticipantsNineteen adult patients with histologically confirmed RG and persistent symptoms (vertigo and/or hearing loss) within 3 months of primary stapes surgery.InterventionRevision surgery included granuloma resection, prosthesis replacement, and corticosteroid-soaked graft placement as needed.Main Outcome MeasuresPostoperative relief of vestibular symptoms, hearing thresholds [pure-tone average (PTA)], and length of hospital stay.ResultsSymptoms developed on average 3.6 ± 3.9 days postoperatively. Revision surgery resolved vertigo in 18 of 19 patients (95%) by discharge (mean 4.8 ± 1.9 days). Audiometric improvement was limited, with 11 patients retaining serviceable hearing. Preoperative versus postoperative bone conduction PTA showed no significant change (P = .58).ConclusionsSurgical management effectively alleviates vestibular symptoms associated with RG but has minimal impact on hearing restoration.RelevanceThis study highlights the efficacy of revision surgery for RG in addressing vestibular symptoms. Further multicenter studies are warranted to better understand reparative granuloma and improve treatment strategies.