Hostname: page-component-6766d58669-rxg44 Total loading time: 0 Render date: 2026-05-19T23:20:34.119Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 10 , October 2012 , pp. 995 - 1002
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

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

References

1Schuknecht, HF, Bartley, ML. Malleus grip prosthesis. Ann Otol Rhinol Laryngol 1986;95:531–4CrossRefGoogle ScholarPubMed
2Sheehy, JL. Stapedectomy: incus bypass procedures. A report of 203 operations. Laryngoscope 1982;92:258–62CrossRefGoogle ScholarPubMed
3Fisch, U, May, JS. Tympanoplasty, Mastoidectomy, and Stapes Surgery. Stuttgart: Georg Thieme Verlag, 1994Google Scholar
4Fisch, U, Acar, FÖ, Huber, A. Malleostapedotomy in revision surgery for otosclerosis. Otol Neurotol 2001;22:776–85CrossRefGoogle ScholarPubMed
5Nandapalan, V, Pollak, A, Langner, A, Fisch, U. The anterior and superior malleal ligaments in otosclerosis: a histopathologic observation. Otol Neurotol 2002;23:854–61CrossRefGoogle ScholarPubMed
6Fisch, U, May, JS, Linder, T. Tympanoplasty, Mastoidectomy and Stapes Surgery, 2nd edn.Stuttgart: Georg Thieme Verlag, 2008CrossRefGoogle Scholar
7Kwok, P, Fisch, U, Nussbaumer, M, Herkenhoff, S, Strutz, J. Morphology of the malleus handle and the comparison of different prostheses for malleostapedotomy. Otol Neurotol 2009;30:1175–85CrossRefGoogle ScholarPubMed
8Yuge, K, Daito, K, Nakamura, K, Murakami, M, Hattori, Y, Murakami, T et al. Results of malleostapediopexy. Auris Nasus Larynx 1982;9:145–50CrossRefGoogle ScholarPubMed
9Colletti, V, Fiorino, FG. Malleus-to-footplate prosthetic interposition: experience with 265 patients. Otolaryngol Head Neck Surg 1999;120:437–44CrossRefGoogle ScholarPubMed
10Vincent, R, Rovers, M, Zingade, N, Oates, J, Sperling, N, Deveze, A et al. Revision stapedotomy: operative findings and hearing results. A prospective study of 652 cases from the otology-neurotology database. Otol Neurotol 2010;31:875–82CrossRefGoogle ScholarPubMed
11Huber, A, Koike, T, Wada, H, Nandapalan, V, Fisch, U. Fixation of the anterior mallear ligament: diagnosis and consequences for hearing results in stapes surgery. Ann Otol Rhinol Laryngol 2003;112:348–55CrossRefGoogle ScholarPubMed
12Dai, C, Cheng, T, Wood, MW, Gan, RZ. Fixation and detachment of superior and anterior malleolar ligaments in human middle ear: experiment and modeling. Hear Res 2007;230:24–33CrossRefGoogle ScholarPubMed
13Schmid, P, Häusler, R. Revision stapedectomy: an analysis of 201 operations. Otol Neurotol 2009;30:1092–100CrossRefGoogle ScholarPubMed
14Fisch, U, Linder, T. Temporal Bone Dissection, the Zurich Guidelines. Tuttlingen: Endo-Press, 2005Google Scholar