Stapedectomy: gelfoam compared with tissue grafts.

The commonest causes of failure with the prefabricated wire loop-gel foam pad technique are inferior displacement of the loop in the window, high membrane formation and window fibrosis. As a result of these problems some members of the Otologic Medical Group have abandoned the use of gelfoam in favor of tissue grafts. A comparison of the results with gelfoam, fat grafts, and fascia grafts in 573 primary cases is made. Tissue grafts yielded a lower incidence of postoperative vertigo, of temporary and permanent sensori-neural hearing impairment, of fistulas and of long-term hearing regression. The conclusion is that a tissue graft is preferable to gelfoam as an oval window covering in stapedectomy.