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Updated: Jun 19, 2026
09:20
Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach
Published on: March 5, 2022
Fisch's reversal steps stapedotomy: when to use it?
Giuseppe Malafronte1, Barbara Filosa
1Department of Otolaryngology Head and Neck Surgery, S. G. Moscati Hospital, Avellino, Italy. gmalafronte@libero.it
Summary
Fisch's reversal steps stapedotomy is recommended for otosclerosis with a blue footplate to avoid complications. This technique is not advised for white footplates, which are associated with increased risks of incus and footplate issues.
Area of Science:
- Otolaryngology
- Neurosurgery
- Surgical Techniques
Background:
- Otosclerosis, a common cause of conductive hearing loss, involves abnormal bone growth affecting the stapes.
- Stapedotomy is a surgical procedure to restore hearing by removing the stapes and replacing it with a prosthesis.
- Fisch's reversal steps technique is a specific approach to stapedotomy aiming to minimize complications.
Purpose of the Study:
- To evaluate the efficacy of Fisch's reversal steps stapedotomy in preventing incus and footplate complications.
- To determine if footplate color (blue vs. white) influences the outcomes of this surgical technique.
Main Methods:
- A prospective study involving 46 otosclerosis patients undergoing stapedotomy using Fisch's reversal steps technique.
- Patients were divided into two groups based on footplate color: blue (Group A, n=34) and white (Group B, n=12).
- Complications, including incus luxation/subluxation and footplate luxation/fracture, were assessed and compared between groups.
Main Results:
- No footplate fractures or luxations occurred in either group during fenestration.
- Group B (white footplate) experienced 5 footplate complications (2 luxations, 3 fractures), significantly more than Group A (blue footplate).
- Incus subluxations occurred in 3 patients in Group B, compared to none in Group A, a statistically significant difference.
Conclusions:
- Fisch's reversal steps stapedotomy is recommended for "blue otosclerosis" (blue footplate) to effectively prevent incus and footplate complications.
- The technique is not recommended for "white otosclerosis" (white footplate) due to a higher incidence of incus and footplate complications.
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