Results of Primary Malleostapedotomy in Stapes Fixation

Abstract

Background and ObjectivesZZThe aim of this study was to analyze the results of malleostapedotomy as primary surgical procedure in stapes fixation. Subjects and MethodZZThis study was a retrospective chart review of 12 patients who underwent primary malleostapedotomy for conductive hearing loss. The intraoperative findings, surgical outcomes including audiologic data and complications were analyzed. ResultsZZNine patients had ossicular fixation with ossicular anomalies and 3 patients had ossicular fixation alone. The median length of piston wire was 5.5 mm in total length. The preoperative mean bone and air-conduction thresholds were 57.5±8.8 (mean±SD) dB, 19.7±10.3 dB, respectively, and the mean air-bone gap (ABG) was 44.6±13.2 dB. After malleostapedotomy, hearings were improved and mean postoperative ABG was 11.1±11.3 dB. In eight patients (66.7%), ABG was reduced to 20 dB or less. There was no intraoperative or postoperative complication except for mild postoperative vertigo for 1 or 2 days. ConclusionZZMalleostapedotomy can be a safe and effective surgical procedure as an alternative of incus stapedotomy in certain cases of absence or anomalous incus long process, and/or immobile incus in patients with stapes fixation. Korean J Otorhinolaryngol-Head Neck Surg 2009;52:961-7 Key WordsZZStapes surgery·Stapes fixation·Conductive hearing loss.