Recurrence of conductive hearing loss after stapes surgery: a narrative review

Among the functional failures of stapes surgery is recurrent conductive hearing loss, which can occur after a variable period of hearing improvement, from days/months up to many years after surgery. The most common cause of recurrent conductive hearing loss is prosthesis displacement, while fibrous adhesions or stapedotomy hole/oval window re-obliteration due to otosclerosis, occur less frequently. High resolution computed tomography plays an important role in the identification of the cause of hearing loss recurrence. Parallel to this, intra-operative exploration of the middle ear is crucial to confirm the cause of failure and address its treatment, possibly restoring hearing. While generally worse than after primary surgery, hearing outcomes after revision stapes surgery have improved thanks to advancements in pre-operative assessment, intra-operative view and technical refinements.