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Updated: Jun 26, 2026

Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Surgery of idiopathic malleus fixation
Cristian Martin1, Alexander Oletski, Jean Michel Prades
1ENT Department of the Saint Etienne University Hospital, Saint Etienne, France.
Objective:
To describe and compare 2 different surgical techniques used in treatment of malleus fixation syndrome.
Study Design:
A retrospective study including 24 patients (25 ears). In 11 of them, the attical fixation was removed via a transmastoid approach without disruption of the ossicular chain. In 14 patients, an ossiculoplasty was performed via a transcanal approach; the malleus head was removed with the incus, and the ossicular chain was reconstructed either by incus interposition (9 cases) or by using a partial ossicular replacement prosthesis (5 cases). The hearing results were analyzed according to the Committee on Hearing and Equilibrium Guidelines of the American Academy of Otolaryngology.
Results:
In the group of attical fixation removed via a transmastoid approach, the preoperative air-bone gap (ABG) attained 25.2 dB, and the postoperative ABG at 1 year followup was 9.1 dB. In the group of ossiculoplasty, the average preoperative ABG reached 26.5 dB, and the postoperative ABG at 1-year follow-up was 8.2 dB.
Conclusion:
There was no statistically significant difference (p = 0.79) between the 2 surgical techniques used to improve hearing in malleus head fixation.
