Surgical problems in some otosclerosis cases

Abstract

The aim of the thesis was the analysis of the anatomical abnormalities and atypical conditions in the middle ear encountered during the surgery for otosclerosis.Among 557 stapedectomies performed in the otosclerotic ears, different abnormalities in the tympanic cavity were found in 122 cases (21.9%). These included: oval window niche narrowed for different reasons in 57 cases, stapes anomalies in 27 cases, obliterate otosclerosis in 20 cases, red otospongiosis of the stapes in 8 cases, increased perilymph pressure in 7 cases and malleus and incus bony fixation in 3 cases.In 28 cases (22.9%), these abnormalities were the reason of some failure during surgery. The most common—16 cases—was premature mobilization of the stapes followed by other consequences. In the other nine cases, the operation was discontinued for different reasons. Another failure was the floating footplate in one ear, facial nerve paresis in one ear and incus subluxation also in one ear. In a few cases in which the operation was stopped, the successful stapedectomy was performed at the second stage. Only in four ears was the stapedectomy totally given up, which makes up 0.7% of the 557 ears operated on.