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[Use of inomeric cement: preliminary results in revision stapes surgery].

OBJECTIVES
Lonomeric cement can be used in revision of stapes surgery to extend the long process of the incus. Indeed, necrosis of the long process of the incus is the most common peroperative finding in this surgery. The objective in this study is to describe the technique and precautions of using SerenoCem, in the reconstruction of the long process of the incus in this indication.


TYPE OF STUDY
Prospective study.


PATIENTS AND METHODS
Consecutive patients with necrosis of the long process of the incus were included from September 2009 to October 2010. We analyzed peroperative findings and evaluated functional results by hearing tests before and three months after surgery.


RESULTS
Nine patients, were included. The preoperative air-bone gap was 29 dB (+/- 14) whereas postoperative air-bone gap was 16 dB (+/- 10). The rate of postoperative air-bone gap closure to within 10 dB was 55% (n = 5). No sensorineural hearing loss occured in this study. Results of revision surgery were more successful when the piston is directly attached to the incus remnant and stabilized with cement, compared to incus reconstruction followed by piston attachment.


CONCLUSION
Ionomeric cement permits reconstruction of the necrosis of the long process of the incus during revision surgery. Preliminary results reveal a significant hearing improvement, without complementary morbidity.