Limitations:
Due to the retrospective setting and the low number of cases, the
statistical power of this study islimited, which could explain why no
statistical difference,but non-inferiority was demonstrated.
The data represents the results of a single institution and a single
surgeon. Evaluation is based exclusively on subjective hearing tests,
however, pure-tone audiometry is still considered as the gold standard
for monitoring hearing outcomes after middle ear surgery.
Conclusion:In our experience, revison stapedotomy is an efficient treatment option
in case of persistent ABG after primary surgery. Periprosthetic fibrosis
is the most common reason behindcompromised audiological outcomes after
stapedotomy. We also concluded that fibrosis formation itself has at
least the same negative effect on ABG development as any other surgical
failure, although revision could be more challenging in such cases.
According to these findings, the exclusion of postoperative inflammatory
reactions in the middle ear are mandatory for optimal results. The role
of perioperative corticosteroid treatment could play a major role in
this process. Further investigation is recommended concerning this
topic.
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