Revision stapes surgery after stapedotomy: A retrospective evaluation of 75 cases.

We retrospectively evaluated a series of 75 surgical revisions after stapedotomy for the treatment of otosclerosis, carried out between 2001 and 2015. Intraoperative findings, causes of failure, and surgical solutions using an angular prosthesis, Causse prosthesis, and glass-ionomer cement were reviewed. Audiometric results performed the day before revision surgery and 1 to 2 months postoperatively were also examined. An incus necrosis was discovered in 65 patients; 55 of whom had partial necrosis of the long process of the incus and 10 with total necrosis. In 5 patients, a dislocation of the foot of the piston alone was recognized, and in 5 patients, a prolapsed facial nerve associated with dislocation of the prosthesis was observed. In this series, the air-bone gap was closed to <10 dB in 89.3%. This percentage differs from that reported in the literature (50 to 60%). No significant postoperative sensorineural hearing loss (>15 dB) was observed in this series. Revision stapes surgery is more difficult and demanding than the first stapes surgery. Revision is a consequence of a delayed erosion of the long process of the incus or a consequence of a poorly performed surgery. Operating in a standardized way, despite the change in basic anatomic conditions, can lead to functional results similar to those of primary surgery.