Stapes revision surgery in two cases of high grade prosthesis dislocation

Introduction Complications after stapes surgery can be classified as early and late complications.

For example, inner ear damage or an extremely rare facial nerve palsy can occur as early complications. As late complications, arrosion of the long incus process and/or prosthesis dislocation can occur, leading to vertigo, bone conduction and air conduction decrease even many years after surgery.

Methods We here report the cases of two patients who presented to our clinic due to late complications many years after stapes surgery elsewhere. A 50 years old patient showed bone conduction and air conduction decrease 17 years after stapes surgery. A 40 years old patient presented air conduction decrease and vertigo occurring during mandibular movements after 13 years stapes surgery. In both patients, cone beam CT showed a severe dislocation of stapes prosthesis.

Results In both cases, the prosthesis could be explanted after scar tissue removal and replaced by a new prosthesis (titanium prosthesis k-piston 0,4x4,25mm; nitinol-titanium- prosthesis Nitiflex 4,24x0,4mm) with significant reduction of symptoms.

Conclusion Even in severe prosthesis dislocations into the vestibule, revision surgery can provide an opportunity for symptom reduction. Decisions to stapes revision surgery should be always consider the increased risk of vertigo, hearing loss up to deafness and discussed individually with the patient.

Poster-PDF A-1816.PDF

Publication History

Article published online:
10 June 2020