Revision stapes surgery is notoriously difficult and results are worse than in primary surgery. This group in Utah have described the use of hydroxyapatite bone cement to stabilise the nitinol prosthesis they use in revision surgery due to incus necrosis related failure. It is worth a read for stapes surgeons as the word limit here is too short to describe the technique in full, and in stapes surgery, it’s all in the detail! There is also a video attached on-line. The results: 27 patients with average follow-up of only seven months. Postoperative closure of the air-bone gap to within 10dB was established in 78%, and closure within 20dB was achieved in 96%. These are excellent results by any standards and better than previous reports on revision stapes surgery. Their excellent results may be due to the rest of their technique rather than the bone cement use and it would have been so useful to have had a comparison group.
Revision stapedectomy with bone cement works well!
Reviewed by Anand Kasbekar
Revision stapedectomy with bone cement: are results comparable to those of standard techniques?
CONTRIBUTOR
Anand Kasbekar
BMedSci, DOHNS, FRCS (ORL-HNS), DM, Nottingham University Hospitals NHS Trust; Associate, The University of Nottingham; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, UK.
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