Skip Navigation LinksHome > September 2014 - Volume 35 - Issue 8 > Management of Incus Necrosis in Revision Stapedectomy Using...
Otology & Neurotology:
doi: 10.1097/MAO.0000000000000496
Otosclerosis

Management of Incus Necrosis in Revision Stapedectomy Using Hydroxyapatite Bone Cement

House, John W.; Lupo, J. Eric; Goddard, John C.

Collapse Box

Abstract

Objective

Review audiological outcomes after revision stapedectomy using hydroxyapatite cement.

Study Design

Retrospective case review.

Setting

Tertiary neurotological referral center.

Patients

Thirty-seven cases of previously treated otosclerosis where incus erosion was observed during revision stapedectomy.

Intervention(s)

Hydroxyapatite cement was used to rebuild the eroded incus and stabilize the prosthesis during revision stapedectomy.

Main Outcome Measure(s)

Pre- and postoperative bone conduction (BC) and air conduction (AC) pure-tone averages (PTA) (0.5, 1, 2, 3 kHz) including high tone BC (1, 2, 4 kHz), air-bone gap (ABG), and speech discrimination scores were measured. Short-term (3 wk) and longer-term (average 12 mo) hearing outcomes were measured. Data are reported according to the most recent guidelines of the AAO-HNS Committee on Hearing and Equilibrium.

Results

Among 37 ears undergoing revision stapedectomy with hydroxyapatite cement, the AC PTA was 59.8 dB preoperatively and 34.6 dB postoperatively (p < 0.0001) at latest follow-up. The mean postoperative ABG was 8.8 dB (SD = 8.6, range −1.3–36.3 dB) while a mean improvement of 2.1 dB (SD = 6.5, range −8.33–15.0 dB) of the high tone BC PTA was observed. One revision case was noted during the follow-up period.

Conclusion

Hydroxyapatite cement is useful to reconstruct and stabilize the prosthesis in revision stapedectomy when erosion of the long process is encountered. Short- and longer-term hearing results are favorable when compared to previously reported results of revision stapedectomy.

Copyright © 2014, Otology & Neurotology, Inc.

Follow Us

 

 

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.