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One hundred twenty-five fat myringoplasties: Does marginal perforation matter?

Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·2017
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Related Experiment Video

Updated: Feb 16, 2026

Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach
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A New Reversal Steps Stapedotomy.

Giuseppe Malafronte1

  • 11 S.G. Moscati Hospital Company of National Importance, Avellino, Italy.

The Annals of Otology, Rhinology, and Laryngology
|January 5, 2018
PubMed
Summary

Removing only the stapes head during stapedotomy significantly reduced footplate complications and improved hearing outcomes in patients with diffuse and biscuit otosclerosis.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Surgical Innovation

Background:

  • Otosclerosis, a common cause of conductive hearing loss, involves abnormal bone growth affecting the stapes.
  • Stapedotomy, a surgical procedure to restore hearing, carries risks of footplate complications.
  • Current techniques for stapedotomy involve varying degrees of stapes superstructure removal.

Purpose of the Study:

  • To investigate if preserving the stapes head during stapedotomy, as opposed to removing the entire superstructure, mitigates footplate complications.
  • To compare hearing results between the two surgical approaches in patients with otosclerosis.

Main Methods:

  • A prospective study involving 145 patients with otosclerosis.
  • Patients were divided into two groups: Group 1 (n=75) underwent complete stapes superstructure removal, and Group 2 (n=70) had only the stapes head removed.
Keywords:
footplate fractureincus luxationotosclerosisreversal steps stapedotomy

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  • Subgroup analysis was performed based on otosclerosis type (marginal, diffuse, biscuit).

    • Main Results:

    • Footplate complications occurred in 9 cases in Group 1b (diffuse/biscuit otosclerosis with complete removal) but none in Group 2b (diffuse/biscuit otosclerosis with head removal only).
    • Air-bone gap closure to within 10 dB was achieved in 65% of Group 1b cases compared to 94.7% in Group 2b.
    • Both differences were statistically significant.

    Conclusions:

    • Removal of only the stapes head during stapedotomy is a safer technique, effectively preventing footplate complications.
    • This modified approach significantly improves hearing outcomes, particularly in patients with diffuse and biscuit forms of otosclerosis.