Indications and possibilities of revision surgery post stapedotomy.

Introduction: Surgical treatment is a standard procedure in cases of otosclerosis and other conditions connected with stapes immobilized in the oval window niche. The most often applied treatment is stapedotomy, meaning the replacement of the immobilized stapes by a prosthesis. The properly conducted operation provides stabile hearing improvement. Aim: The paper aims to present failures after stapedotomy operations, audiometric indications for the future operation, and postoperative changes occurring within the middle and inner ear in comparison to the hearing and balance examinations' results. Material: The authors of the paper conducted a retrospective analysis of the reoperation cases after prior stapedectomies and stapedotomies performed in our clinic and in other clinics. The authors present causes of the airbone gap occurring postoperatively, as well as other difficult conditions after repeated operation. The authors discuss indications for reoperations and possibilities of the middle ear reconstructions. Results: Treatment is assessed based on the long term followup of the patients, otoscopic examination and results of pure tone audiometry and analysis of intraoperative assessments. Conclusions: Correctly performed operation with properly chosen prosthesis allows obtaining hearing improvement with closure of the air-bone gap. Reoperation is always a great challenge for the surgeon, and it requires experience and skills to reconstruct the middle ear. Proper assessment of the patient's condition before next operation allows lower the surgical risk and helps to choose surgical tactics. [ABSTRACT FROM AUTHOR]