Myringostapediopexy: surgical expectation.

Area of Science:

• Otolaryngology
• Surgical Innovation
• Audiology

Background:

• Myringostapediopexy can arise from incus erosion, leading to tympanic membrane medialization.
• It is recognized for often preserving serviceable hearing.
• This technique is applicable in tympanoplasty after chronic otitis media surgery (canal wall up or down).

Purpose of the Study:

• To review and compare hearing levels associated with myringostapediopexy.
• To evaluate hearing outcomes based on the formation (natural vs. surgical) and surgical approach (canal wall up vs. down).

Main Methods:

• Review of hearing levels in patients with myringostapediopexy.
• Comparison of audiometric outcomes between naturally formed and surgically created myringostapediopexy.
• Analysis of hearing results based on surgical technique (canal wall up vs. canal wall down).

Main Results:

• A similar range of hearing levels was observed for naturally formed and surgically fashioned myringostapediopexy.
• Approximately 80% of patients undergoing myringostapediopexy following canal wall up surgery achieved an air-bone gap of 20 dB or less.
• Approximately 60% of patients undergoing myringostapediopexy following canal wall down surgery achieved an air-bone gap of 20 dB or less.

Conclusions:

• Myringostapediopexy is an effective reconstructive technique for chronic otitis media, often yielding serviceable hearing.
• Canal wall up surgery in conjunction with myringostapediopexy demonstrates superior hearing preservation compared to canal wall down surgery.
• The anatomical considerations post-disease excision influence the choice and outcome of myringostapediopexy reconstruction.