Addressing postoperative complications
In this article, we will explore left stapes revision surgery for the Dr. Vincent, prominent otorhinolaryngologist surgeon in the Causse Ear Clinic in Béziers, France. This surgical intervention, designed to address postoperative complications in a patient previously operated on by a neurosurgeon, focuses on the removal of a previous prosthesis and reducing the risk of hearing loss after surgery. The video of the surgery has been shared on the surgical training app. SURGSCHOOL.
Postoperative Challenges and Diagnosis
The patient has postoperative dizziness along with a typical fistula sign and pressure on the triggers. Based on CT scan findings, these complications appear to be related to a previously placed long prosthesis.
Surgical Approach
During surgery, Dr. Vincent faces several challenges, starting with careful dissection of fibrous tissue around the window. A Shuknesh hook is used to prevent damage to the facial nerve while the tissue is removed. The strong adhesion of the prosthesis to the inner ear requires meticulous removal to avoid injury.
Prosthesis Removal and Technical Considerations
The long prosthesis, composed of a titanium loop and a plastic shaft, Removed cautiously to avoid trauma to the inner ear. Surgery includes opening the loop with a hook and placing a suction cup to facilitate removal. A dehiscent facial nerve is observed, which increases the complexity of the procedure.
Insertion of the New Prosthesis and Closure
Once the previous prosthesis is removed, the distance from the platen to the incus is measured and a new Teflon piston of suitable length is placed. It uses a vein graft to seal the platen and the stability of the prosthesis is verified to ensure the patient's hearing restoration. The surgery concludes with the placement of a Merocel for closure.
