Stapedectomy in military aircrew.

Stapedectomy in military aircrew is generally considered to be the end of an aviation career. Perilymphatic fistulae, prosthesis dislodgement, and perforation of the vestibule are recognized complications of stapedectomy. Consequently, barotrauma, G forces, and otherwise hostile conditions and their effects on the poststapedectomy ear are usually cited as reasons for grounding. Data supporting such a restrictive policy, however, are limited. This study examined the aeromedical outcome of 16 U.S. Air Force aircrew members who returned to flight duty after stapedectomy between 1965 and 1992. Selected patients were subjected to centrifuge and altitude chamber testing before they returned to flight duty. No episodes of sudden hearing loss or vestibulopathic conditions have occurred in the entire study group. Guidelines for surgical technique, reconstruction materials, and postoperative aeromedical testing are proposed for evaluating selected stapedectomy patients before their return to flight status.