# Audiological outcomes after revision stapes surgeries: a systematic review

## TL;DR

This study reviews audiological outcomes of revision stapes surgeries to establish realistic success thresholds.

## Contribution

The study provides audiological standards for revision stapes surgery outcomes based on systematic data analysis.

## Key findings

- Average air–bone gap gain was 17.3 dB after revision stapes surgery.
- Postoperative air–bone gap of 11.1 dB was observed with 53.3% within 0–10 dB.
- Surgical complications like SNHL occurred in 1.6% of cases.

## Abstract

Revision stapes surgery is a challenging procedure performed in relatively small numbers compared to other middle ear procedures. Despite numerous data on hearing results of different middle ear surgeries, the audiological standards for successful outcome of this procedure are still not clarified. On the basis of well-documented data, we wanted to determine what the expected audiological results and complications are after revision stapes surgery in order to set a realistic threshold for surgical success.

After the protocol registration in the PROSPERO database, a systematic review was performed in multiple databases (PubMed, Cochrane, Web of Science, Scopus, ScienceOpen, ClinicalTrials.gov, Google Scholar) according to PRISMA guidelines. Twelve articles were reviewed according to the inclusion criteria. A total of 1032 cases were obtained for evaluation. A modified version of Newcastle–Ottawa Scale (NOS) was used to assess publication quality.

Average air–bone gap (ABG) gain was 17.3 dB, average air conduction (AC) gain was 17.5 dB. The average postoperative air–bone gap was 11.1 dB. The postoperative ABG distribution was the following 0–10 dB: 53.3%, > 10–20 dB: 28.2%, > 20 dB: 18.5%. SNHL as a surgical complication was described in a total of 17 cases (1.6%), no equilibrium disorder was reported.

The pooled data suggest that revision stapes surgery is an effective solution after failure of previous stapes surgery. However, the results are clearly inferior to those of primary stapedotomies. Hence, we need to apply different expectations and use different standards in the indication and evaluation of this type of surgery.

The online version contains supplementary material available at 10.1007/s00405-024-08741-7.