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From incus bypass to malleostapedotomy: technical improvements and results

Published online by Cambridge University Press:  19 September 2012

A Rambousek ,
C H Schlegel  and
T E Linder
A Rambousek
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kantonsspital Luzern, Lucerne, Switzerland
C H Schlegel
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kantonsspital Luzern, Lucerne, Switzerland
T E Linder*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Kantonsspital Luzern, Lucerne, Switzerland
*
Address for correspondence: Prof Thomas Linder, Department of Otorhinolaryngology – Head and Neck Surgery, Kantonsspital Luzern, Spitalstrasse, CH 6000 Lucerne, Switzerland Fax: +41 41 205 4995 E-mail: Thomas.Linder@luks.ch
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Abstract

Objective:

To assess results of malleostapedotomy using a Fisch Storz titanium piston with at least 10 months’ follow up.

Methods:

Using a prospective database, the indications, surgical technique, and pre- and post-operative audiometric data for 60 patients undergoing malleostapedotomy between 2002 and 2010 were evaluated. Diagnoses and primary and revision surgeries were compared with reference to the literature.

Results:

Sixty endaural malleostapedotomies were performed, 28 as a primary intervention and 32 as revision surgery. In 68 per cent, the underlying pathology was otosclerosis. The most common reason for revision surgery (i.e. in 59 per cent) was prosthesis dysfunction. Overall, the mean air–bone gap (0.5–3 kHz) for the primary intervention and revision surgery groups was 9.4 and 11.3 dB, respectively; an air–bone gap of less than 20 dB was obtained in 100 and 81 per cent of patients, respectively. There was no significant audiological difference between the primary and revision surgeries groups, and no deafness.

Conclusion:

Malleostapedotomy shows comparable results to standard incus-stapedotomy and may be preferable in the presented situations.

Keywords

Conductive Hearing LossMalleusOtosclerosisStapes SurgeryOtologic Surgical ProceduresOssicular Replacement ProsthesisTreatment Outcome
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 10 , October 2012 , pp. 995 - 1002
Copyright
Copyright © JLO (1984) Limited 2012

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Footnotes

Presented at the Annual Spring Conference of the Swiss Society of Oto-Rhino-Laryngology, Head and Neck Surgery, 17–18 June, 2010, Zurich, Switzerland

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