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.