Revision Stapes Surgery: The Malleus to Oval Window Wire-Piston Technique†

Objective To determine the effectiveness of the malleus to oval window wire-piston revision stapes surgery technique. Study Design A retrospective analysis of 243 stapes procedures performed by the senior author over a 10-year period identified 15 revisions. Five patients underwent a malleus to oval window wire-piston technique. All patients were followed for at least 6 months. The surgical outcome including audiologic data and complications are noted. Methods Stapes surgery was performed on an ambulatory basis by way of a transcanal approach under local anesthesia with monitored sedation by the same surgeon using a laser technique and a stapes wire-piston prosthesis. Results Among revision stapes procedures, there was no significant difference in the air-bone gap closure or complication rate between the incus to oval window and the malleus to oval window techniques. The average preoperative air-bone gap in all revisions was 32 dB, whereas the mean postoperative gap was 10 dB hearing loss. Conclusions In experienced hands, revision stapes surgery using the malleus to oval window stapes wire-piston prosthesis is safe and effective.