Revision surgery in otosclerosis--operative findings in 186 patients

Over a 14-year-period 186 revision operations for otosclerosis were performed. In 90% of the patients the indication for revision was too large an air-bone-gap. A number of different surgical techniques had been used at the primary operation. The purpose of the investigation was to describe the middle ear abnormality at the revision operation. Most often adhesions, acentric prosthesis, reobliteration and necrosis of the long process of the incus were found. The middle ear abnormality found at revision operation was correlated to the primary surgical technique used and the information obtained can be of value, when a revision operation is considered. The surgical technique used at revision operation was determined by the operative findings. The best hearing improvement was obtained when a small-fenestration-technique was used primarily or as the method for revision. In revision stapes surgery, the experience of the surgeon is important and centralization of this type of operation is recommended.