Revision stapedectomy with and without the CO2 laser: an analysis of results

A retrospective review is presented of revision stapedectomies performed by the senior authors between 1986 and 1994. A total of 106 stapedectomies was performed during that period, of which 30 were revisions. These revisions were within the first 100 stapedectomies performed by the senior authors. Most failures occurred early in the series. The overall success rate for closure to within 10 dB was 52%, and the average closure was 12.72 dB. Five cases were performed without the laser with no successes and an average closure of 27 dB. After the use of the laser, the success rate was 64%, and the average closure was 9.75 dB. There was a statistically significant difference between the hearing results with and without the laser (p < 0.01). The prognosis was better when surgery was performed primarily for hearing loss and with the laser, with success in 13 (72%) or 18 cases. In two cases, there was a sensorineural decline > 10 dB. The only dead ear occurred preoperatively in a patient with a granuloma. We have found the use of the CO2 laser in revision stapedectomy to be a safe technique that produces reliable results.