The long term effect of malleostapedotomy in ossicular chain reconstruction

Abstract

Objective:To analysis the long-term outcomes of ossicular chain reconstruction using the malleostapedotomy（MT）. Method:A total of 11 patients（12 ears） underwent MT and their hearing levels were measured prior to surgery, 1 week and more than 1 year after surgery. The indications of MT were discussed and its safety and efficacy were evaluated in terms of the intra-operative findings, post-operative hearing and complications. Result:Among 11 patients（12 ears）, there were 1 patient（1 ear） with tympanosclerosis, 3 patients（4 ears） with ossicular chain deformity, 5 patients（5 ears） with otosclerosis and 2 patients（2 ears） with localized cholesteatoma of the middle ear. No cases of bone conduction hearing loss（more than 10 dB） were observed within 2 weeks after surgery while four patients suffered from short-term vertigo with an average remission duration of 3 days. And no recurrence was found in the two patients with cholesteatoma. After a follow-up of 1-6 years, we found a remarkable improvement of air conduction without bone conduction loss in all patients and there was a significant difference between preoperative and post-operative air-bone gap（P<0.05）. Conclusion:With a strict selection according to the indications, MT showes safe and effective long-term outcomes and is proved to be applicable in ossicular chain reconstruction in the cases of fixation of the stapes footplate accompanied with malleus/incus mobility disorder by various causes.