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.