Malleostapedotomy in stapes revision surgery: Is an endoscopic approach possible?

The purpose of the present study was to show our preliminary results regarding the endoscopic ear surgery application in malleostapedotomy surgery.

Case series.

Six patients (four females and two males) who underwent endoscopic ear surgery as revision surgery for otosclerosis were enrolled in this study. For endoscopic malleostapedotomy surgery, rigid angled endoscopes at 0 ° and 30 ° with a length of 14 cm and an outer diameter of 3 and 4 mm were used. A superelastic nitinol stapes prosthesis was used to connect the malleus neck to the oval window.

During endoscopic ear surgery, a lateral ossicular chain fixation was present in all cases. The mean operative time in the study group was 81 minutes (range, 73-89 minutes). A statistically significant difference between preoperative and postoperative hearing findings was observed (P = .007). No cases of sensorineural hearing loss or persistent vertigo were observed in the study sample. No cases of prosthesis displacement or prosthesis extrusion occurred after a mean follow-up of 11.5 months.

In 100% of treated cases, the endoscope proved to be adequate for the visualization of the malleus handle and incus, and of their possible abnormalities. Despite the difficulty related to endoscopic single-handed work, none of the surgical steps of endoscopic malleostapedotomy were considered not feasible by endoscopic ear surgery.

4. Laryngoscope, 2611-2614, 2018.