AIM: The aim of the present study is to identify the various reasons for a new surgical procedure to be decided on. In spite of several technical alterations, such as total platinectomy, partial platinectomy, bone interposition, fenestration in the footplate and the use of different types of prosthesis, there are still many problems concerning the improvement of impaired hearing, partly due to insufficient training of resident doctors at the University Centers, where the number of stapedial surgeries has been decreasing year after year. This creates a situation in which our resident doctors have little opportunity to gain experience in this area. STUDY DESIGN: Retrospective Evaluation. MATERIAL AND METHOD: The study was based on 74 cases of revision stapedectomy, performed in 68 patients, being that 47 ears were submitted to revision and all of them have been previously operated on by the first author above mentioned, out of a population of 725 stapedectomies performed at Antonio Pedro University Hospital (HUAP) Federal University of the State of Rio de Janeiro (UFF) / Niterói-RJ, from July 1980 to June 1999. We added 21 more cases of revision surgery originated elsewhere. As far as obliteration of the oval window was concerned, for which cutting drills were used, there were 04 cases of variable sensorineural hearing loss and 02 cases of anacusis. The cases of vertigo and / or loss of balance with possible perilymphatic fistula were solved by means of replacement of the long prosthesis by a smaller one, the vertigo and/or loss of balance being thus eliminated. We conducted the audiologic follow-up of all operated ears 06 months after the surgery and of 66 operated ears, 08 patients had not undergone a second examination 01 year after. Auditory postoperative results depend on the surgical pathology found, not only because of the presence or absence of the incus but also because of the osseous reobliteration of the oval window. CONCLUSION: Considering all revisionsurgery cases, the auditory gains obtained were the following: for 78.3% of the patients, the auditory threshold was as low as 20db, for 10.8% of the patients, it ranged from 20dB to 25dB, and for 8.2% of the patients, it was only above 25%; there was anacusis in 2.7% of the patients. The standard audiologic evaluation included pure tone threshold for air and bone conduction at 250, 500, 1000, 2000, 4000 and 8000Hz, speech recognition threshold and speech discrimination score. The PTA at 500, 1000 and 2000 was calculated for air and bone curves from both preoperative and postoperative audiograms.
otosclerosis; conductive deafness; surgery; stapedectomy; stapedotomy
