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Malleostapedotomy: the Marburg experience
C V Dalchow1, A A Dünne, A Sesterhenn
1Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Marburg, Germany.
Background:
The surgical procedure for patients with otosclerosis routinely is incus stapedotomy. In case of otosclerosis with incus necrosis or a bony fixation of the malleus and incus, malleostapedotomy is performed.
Patients And Methods:
Between May 2002 and September 2003, malleostapedotomy was performed in 6 out of 34 patients with otosclerosis. In 2 primary cases, a middle ear dysplasia was found. The malleus was fixed in 2 further primary cases. Two revision surgeries were performed with incus necrosis present. A titanium piston was used, which was fixed at the malleus handle and introduced into an opening of the footplate.
Results:
The preoperative air-bone gap was reduced from 36 dB(A) to 13 dB(A) after surgery for an average checkup time of 3 months. The length of the prostheses varied from 6.3 to 7.5 mm. No patient showed a hearing loss or vertigo after surgery.
Conclusion:
Malleostapedotomy is the technique of choice in case of an additional pathology of the ossicular chain in patients with otosclerosis. Larger numbers of patients and long-term investigations need to compare the results of malleostapedotomy with those of a conventional incus stapedotomy.
Insights
Malleostapedotomy effectively addresses otosclerosis complications like incus necrosis. This surgical technique significantly improves the air-bone gap, offering a viable alternative to standard procedures when ossicular chain issues are present.
Area of Science:
- Otolaryngology
- Neurosurgery
- Surgical Innovation
Background:
- Otosclerosis commonly involves incus stapedotomy.
- Malleostapedotomy is indicated for otosclerosis with incus necrosis or malleus/incus fixation.
- This study evaluates malleostapedotomy in complex otosclerosis cases.
Purpose of the Study:
- To assess the efficacy of malleostapedotomy in patients with otosclerosis and additional ossicular chain pathologies.
- To report surgical outcomes and audiological results of malleostapedotomy.
Main Methods:
- Malleostapedotomy was performed on 6 out of 34 otosclerosis patients between May 2002 and September 2003.
- Indications included middle ear dysplasia, malleus fixation, and incus necrosis.
- A titanium piston prosthesis was utilized, secured to the malleus handle and inserted into the footplate.
Main Results:
- Preoperative air-bone gap improved from 36 dB(A) to 13 dB(A) at a 3-month average follow-up.
- Prosthesis lengths ranged from 6.3 to 7.5 mm.
- No instances of hearing loss or vertigo were observed post-surgery.
Conclusions:
- Malleostapedotomy is a preferred technique for otosclerosis with concurrent ossicular chain pathology.
- Further research with larger patient cohorts and long-term follow-up is necessary to compare malleostapedotomy with incus stapedotomy.
