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Otosclerosis revision surgery in Sweden: hearing outcome, predictive factors and complications

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To describe the procedures and investigate the hearing outcomes and complications after revision surgery for patients with otosclerosis in Sweden and compare these with previously published reports and to investigate factors that may predict the outcomes of revision surgery.

Methods

A total of 254 patients from the Swedish Quality Register for otosclerosis surgery who underwent surgery at 21 clinics were identified as having undergone revision surgery for otosclerosis from 2003 to 2013. Clinical records and audiograms from each of these patients were collected and analyzed.

Results

Improvement in hearing by 20 dB or more and closure of air–bone gap (≤ 20 dB) was achieved in 43% and 69% of patients after a first revision operation and in 46% and 70% of patients after a second revision operation. Most patients who underwent surgery because of dizziness were relieved of their dizziness. Postoperative deafness occurred in 2.3% of patients. Prior successful otosclerosis surgery predicted successful revision surgery, especially after a second revision operation. Fixation of the incus or malleus and finding of no obvious reason for the conductive hearing loss predicted a worse hearing outcome.

Conclusions

The hearing results after revision surgery in Sweden is somewhat inferior to those of previously published results involving large centers. Postoperative deafness may be as much as fivefold more common after revision surgery than after primary surgery. Meticulous reading of previous charts and honest counseling regarding the risks and expectations is mandatory before planning revision surgery for otosclerosis.

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References

  1. Skrivan J, Cada Z, Kluh J, Boucek J, Profant O, Betka J (2014) Revision operations after previous stapes surgery for persisting hearing loss. Bratisl Lek Listy 115(7):442–444

    CAS  PubMed  Google Scholar 

  2. Albers AE, Schönfeld U, Kandilakis K, Jovanovic S (2013) CO2 laser revision stapedotomy. Laryngoscope 123(6):1519–1526

    Article  Google Scholar 

  3. Stucken EZ, Brown KD, Selesnick SH (2012) The use of KTP laser in revision stapedectomy. Otol Neurotol 33(8):1297–1299

    Article  Google Scholar 

  4. Thiel G, Mills R (2011) Persistent and recurrent conductive deafness following stapedotomy. J Laryngol Otol 125(5):460–466

    Article  CAS  Google Scholar 

  5. Bakhos D, Lescanne E, Charretier C, Robier A (2010) A review of 89 revision stapes surgeries for otosclerosis. Eur Ann Otorhinolaryngol Head Neck Dis 127(5):177–182

    Article  CAS  Google Scholar 

  6. Vincent R, Rovers M, Zingade N, Oates J, Sperling N, Devèze A, Grolman W (2010) Revision stapedotomy: operative findings and hearing results. A prospective study of 652 cases from the Otology-Neurotology Database. Otol Neurotol 31(6):875–882

    Article  Google Scholar 

  7. Babighian GG, Albu S (2009) Failures in stapedotomy for otosclerosis. Otolaryngol - Head Neck Surg 141(3):395–400

    Article  Google Scholar 

  8. Mangham CA (2009) Long-term impact of incus necrosis on revision stapes surgery: incus versus malleus reconstruction. Otol Neurotol 30(8):1145–1151

    Article  Google Scholar 

  9. Schmid P, Häusler R (2009) Revision stapedectomy: an analysis of 201 operations. Otol Neurotol 30(8):1092–1100

    Article  Google Scholar 

  10. Gros A, Vatovec J, Zargi M, Jenko K (2005) Success rate in revision stapes surgery for otosclerosis. Otol Neurotol 26(6):1143–1148

    Article  Google Scholar 

  11. Puxeddu R, Ledda GP, Pelagatti CL, Salis G, Puxeddu P (2005) Revision stapes surgery for recurrent transmissional hearing loss after stapedectomy and stapedotomy for otosclerosis. Acta Otorhinolaryngol Ital organo Uff della Soc Ital di Otorinolaringol e Chir cervico-facciale 25(6):347–352

    CAS  Google Scholar 

  12. Kohan D, Sorin A (2003) Revision stapes surgery: the malleus to oval window wire-piston technique. Laryngoscope 113(9):1520–1524

    Article  Google Scholar 

  13. Lippy WH, Battista RA, Berenholz L, Schuring AG, Burkey JM (2003) Twenty-year review of revision stapedectomy. Otol Neurotol 24(4):560–566

    Article  Google Scholar 

  14. De La Cruz A, Fayad JN (2000) Revision stapedectomy. Otolaryngol Head Neck Surg 123(6):728–732

    Article  Google Scholar 

  15. Hammerschlag PE, Fishman A, Scheer AA (1998) A review of 308 cases of revision stapedectomy. Laryngoscope 108(12):1794–1800

    Article  CAS  Google Scholar 

  16. Shea JJ (1998) Forty years of stapes surgery. Am J Otol 19:52–55

    PubMed  Google Scholar 

  17. Han WW, Incesulu A, McKenna MJ, Rauch SD, Nadol JB, Glynn RJ (1997) Revision stapedectomy: intraoperative findings, results, and review of the literature. Laryngoscope 107(9):1185–1192

    Article  CAS  Google Scholar 

  18. Magliulo G, Cristofari P, Terranova G (1997) Functional hearing results in revision stapes surgery. Am J Otol 18(4):408–412

    CAS  PubMed  Google Scholar 

  19. Somers T, Govaerts P, de Varebeke SJ, Offeciers E (1997) Revision stapes surgery. J Laryngol Otol 111(3):233–239

    Article  CAS  Google Scholar 

  20. Battista RA, Wiet RJ, Joy J (2006) Revision Stapedectomy. Otolaryngol Clin. North 39(4):677–697

    Google Scholar 

  21. Pauli NP, Strömbäck K, Lundman L, Dahlin-Redfors Y (2019) Surgical technique in stapedotomy hearing outcome and complications. Laryngoscope. https://doi.org/10.1002/lary.28072

    Article  PubMed  Google Scholar 

  22. Strömbäck K, Lundman L, Bjorsne A, Grendin J, Stjernquist-Desatnik A, Dahlin-Redfors Y (2017) Stapes surgery in Sweden: evaluation of a national-based register. Eur Arch Oto-Rhino-Laryngology 274(6):2421–2427

    Article  Google Scholar 

  23. Wegner I, Vincent R, Derks LSM, Rauh SP, Heymans MW, Stegeman I, Grolman W (2018) An internally validated prognostic model for success in revision stapes surgery for tosclerosis. Laryngoscope 128:2390–2396

    Article  Google Scholar 

  24. Lachance S, Bussières R, Côté M (2012) Stapes surgery in profound hearing loss due to otosclerosis. Otolo Neurotol 33:721–723

    Article  Google Scholar 

  25. Merkus P, van LOON MC, Smit CF, Smits C, de Cock AF, Hensen EF (2011) Decision making in advanced otosclerosis: an evidence-based strategy. Laryngoscope 121:1935–1941

    PubMed  Google Scholar 

  26. Mangam CA (2009) Long-term impact of incus necrosis on revision stapes surgery: incus versus malleus reconstruction. Otol Neurotol 30:1145–1151

    Article  Google Scholar 

  27. Rambouesek A, Schlegel CH, Linder TE (2012) From incus bypass to malleostapedotomy: technical improvements and results. J Laryngol Otol 126(10):995–1002

    Article  Google Scholar 

  28. Whetstone J, Nguyen A, Nguyen-Huynh A, Hamilton BE (2014) Surgical and clinical confirmation of temporal bone CT findings in patients with otosclerosis with failed stapes surgery. Head Neck 35(6), 1195–120129. Guyot J-P, Sakbani K (2007) Patients’ lives following stapedectomy complications. Adv Otorhinolaryngol 65:348–352

    Google Scholar 

  29. Ramaswamy AT, Lustig LR (2018) Revision surgery for otosclerosis. Otolaryngol Clin North Am 51:463–474

    Article  Google Scholar 

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Acknowledgement

Jan Eklund, Centre of Registers Västra Götaland for statistical analysis.

Funding

This work was funded by the Swedish Association for Otorhinolaryngology Head Neck Surgery and the Center for Clinical Research in Värmland, Sweden.

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Central Hospital, 651 85, Karlstad, Sweden

    Lars Lundman

  2. Department of Surgical Sciences, Otorhinolaryngology, Head and Neck Surgery, Uppsala University, Uppsala, Sweden

    Karin Strömbäck

  3. Hearing Organisation Habilitation and Health, Region Västra Götaland, Sweden

    Andreas Björsne

  4. Östersund Hospital, Östersund, Sweden

    Joakim Grendin

  5. Department of Otorhinolaryngology, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden

    Ylva Dahlin-Redfors

Authors
  1. Lars Lundman
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  2. Karin Strömbäck
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  3. Andreas Björsne
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  4. Joakim Grendin
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  5. Ylva Dahlin-Redfors
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Corresponding author

Correspondence to Lars Lundman.

Ethics declarations

Conflict of interest

All authors are members of the professional committee that administrate the Swedish Quality Register for Otosclerosis Surgery (SQOS). Author Lars Lundman is also chairman for the National Quality Register for ENT-healthcare, in which SQOS is a part.

Informed consent

For this retrospective study spanning over a period of more than 1 decade, the Regional Ethics Committee in Uppsala, Sweden (ref. 2015/377) has approved collection of clinical data as described in the Materials and methods section, without written informed consent from each patient. The patients gave their informed consent to be registered in the SQOS database at the time of surgery and were then informed that the data could be used for clinical research in the future.

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Lundman, L., Strömbäck, K., Björsne, A. et al. Otosclerosis revision surgery in Sweden: hearing outcome, predictive factors and complications. Eur Arch Otorhinolaryngol 277, 19–29 (2020). https://doi.org/10.1007/s00405-019-05652-w

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  • DOI: https://doi.org/10.1007/s00405-019-05652-w

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