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The Use of Cartilage in Revision Stapedectomy

Berenholz, Leonard P.; Burkey, John M.; Lippy, William H.

doi: 10.1097/MAO.0000000000000241
Middle Ear and Mastoid Disease

Objective To evaluate the incidence of stapedectomy patients who developed significant chronic ear disease resulting in reconstruction of the tympanic membrane with cartilage and concomitant revision stapedectomy. Audiometric results of this subgroup within revision stapedectomy are analyzed, and the salient features of the reconstruction method are discussed.

Study Design Retrospective study of revision stapedectomy patients during the years 2003–2012.

Setting Tertiary referral center.

Intervention Cartilage tympanoplasty and revision stapedectomy.

Results Seventeen patients (18 ears) of 144 revision stapes patients were studied who required cartilage tympanoplasty and revision stapedectomy. One-half underwent revision stapedectomy with a modified Lippy prosthesis (MLP), and one-half required a total ossicular prosthesis (TOP). The mean postoperative air-bone gap (ABG) was 11.1 dB with mean pure tone average (PTA) hearing improvement of 15.6 dB.

The rate of ABG closure was 55.6% <10 dB and 38.8 % >10 dB and <20 dB.

Conclusion The number of patients requiring revision stapedectomy due to significant chronic ear disease is small. This paper discusses the management and successful outcome of these more difficult revisions.

Lippy Group for Ear, Nose and Throat, Warren, Ohio, U.S.A.

Address correspondence and reprint requests to Leonard Berenholz, M.D., Lippy Group, 3893 E. Market St., Warren, OH 44484; E-mail: info@lippygroup.com.

The authors disclose no conflicts of interest.

Copyright © 2014 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company