[Complications of three methods of stapedectomy]

In a group of 270 partial stapedectomies performed by one surgeon using teflon-piston prosthesis it was assessed whether incidence of complications depended on sequence of surgical steps. In group I of 50 ears classical stapedectomy was performed: 1. removal of stapes superstructure, 2. making a hole in the footplate, 3. placing the prosthesis on the incus. In group II of 167 ears the hole in the footplate was made before removal of stapes arch. In group III of 53 ears: 1. the hole in the footplate, 2. placing the prosthesis on the incus, 3. removal of stapes arch, was performed. Total deafness had one patient of the whole group. No patient had perilymphatic fistula and facial nerve palsy. Floating footplate developed in 4 patients of group I, in one patient of group II and in none patient of group III. Subluxation of incus developed in 3 patients of group I, in 12 patients of group II and in none patient of group III. Comparison of three stapedectomy methods showed that making the hole in the footplate before removal of stapes arch prevents floating footplate and placing the prosthesis on the incus before removal of stapes arch prevents subluxation of the incus.