Post-stapedectomy granulomas, experience at the Luis Guillermo Ibarra National Rehabilitation Institute Ibarra

Abstract

Otosclerosis is a progressive bone remodeling disease that leads to hearing loss. The most performed surgery is stapedectomy, whose complications include necrosis of the incus, tympanic perforation, facial nerve injury, dysgeusia, perilymphatic fistula, and granuloma formation.

The incidence of granuloma is variable (0.07% in stapedotomy and 0.1% in stapedectomy). Its genesis is attributed to a reaction to a foreign body, a clot over the oval window, or mucosal irritation secondary to a perilymphatic fistula or gastric content.

Symptoms can appear from the first week after surgery and up to six months later. They are characterized by sudden or progressive sensorineural hearing loss accompanied by vertigo, otalgia, imbalance and/or tinnitus.

The treatment is controversial and the following have been described: immediate or late reintervention for removal of granulation tissue, prosthesis and/or graft material, administration of antibiotics or intratympanic steroids.

We present a retrospective and cross-sectional study of the experience in the INR LGII with 5 cases (3 women and 2 men) between 2008 and 2021 with post-stapedectomy granuloma formation.

Surgical treatment was performed in three cases and intratympanic steroid was administered in two. The aims of this study were to describe the clinical manifestations and the physical examination findings of the reported cases, as well as the tomographic, histopathological and audiometric findings.