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Revision stapedectomy for incus erosion: long-term hearing
L W Krieger1, W H Lippy, A G Schuring
1Community General Hospital, Syracuse, New York, USA.
Summary
Incisal erosion is a common issue in revision stapedectomy. The Robinson prosthesis may reduce erosion risk, while the Lippy modified prosthesis offers good long-term outcomes, especially in primary cases.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Audiology
Background:
- Incus erosion is a frequent complication in revision stapedectomy surgery.
- Long-term outcomes and prosthesis-related erosion associations require further investigation.
- Previous studies report 1-year success rates for revision surgery between 70% and 80%.
Purpose of the Study:
- To evaluate the long-term efficacy of stapedectomy using the Lippy modified prosthesis.
- To assess the association between incus erosion and different types of prostheses.
- To analyze outcomes in revision versus non-revision stapedectomy cases.
Main Methods:
- Retrospective analysis of 83 stapedectomy cases over 1 to 20 years.
- Surgery performed under local anesthesia using the Lippy modified prosthesis.
- Evaluation of incus erosion, prosthesis type, and hearing outcomes.
Main Results:
- Initial success rates with the Lippy prosthesis were 72%, with 90% satisfactory results.
- At 10 years, success declined to 50%, with 80% satisfactory outcomes.
- The Robinson prosthesis showed a lower association with incus erosion compared to crimped wire or plastic strut prostheses.
Conclusions:
- The Lippy modified prosthesis demonstrates favorable long-term results, particularly when incus erosion is present initially.
- The Robinson prosthesis may be associated with a reduced risk of incus erosion.
- Outcomes in revision stapedectomy cases, especially multiple revisions, are generally less favorable than in primary procedures.