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Step-by-Step Stapedotomy through Transcanal Exclusive Endoscopic Approach

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Published on: March 5, 2022

Predictable prosthesis length on a high-resolution CT scan before a stapedotomy.

Emilie Gosselin¹, Ahlem Elblidi¹, Salman F Alhabib¹

¹Division of Otolaryngology Head and Neck Surgery, Montreal University Hospital Center (CHUM), Notre-Dame Hospital, University of Montreal, 1051 Sanguinet St, Montreal, QC, H2X 3E4, Canada.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

|July 29, 2018

Summary

High-resolution CT (HRCT) imaging accurately predicts stapedotomy prosthesis length, aiding surgical planning. HRCT may also help identify facial nerve prolapse, optimizing stapedotomy procedures.

Keywords:

HRCT (high-resolution CT scan)Otosclerosis Prosthesis length Prosthesis measurement Stapedectomy Stapedotomy

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Area of Science:

Otolaryngology
Medical Imaging
Neurosurgery

Background:

Stapedotomy is a common surgical procedure for hearing loss.
Accurate prosthesis selection is crucial for successful stapedotomy outcomes.
Preoperative imaging can potentially improve surgical planning and patient safety.

Purpose of the Study:

To evaluate the correlation between preoperative high-resolution CT (HRCT) measurements and intraoperative prosthesis length in stapedotomy.
To determine the predictive value of HRCT for identifying a prolapsed facial nerve during stapedotomy.

Main Methods:

A retrospective case series of 94 patients undergoing primary stapedotomy.
Preoperative temporal bone HRCT scans were analyzed to measure the incus long process to footplate distance.
Interobserver correlation and correlation with intraoperative prosthesis length were assessed.

Main Results:

Mean HRCT measurement showed a strong correlation with the mean intraoperative prosthesis length (ICC=0.791, p<0.001).
Statistically significant improvements in air conduction, bone conduction, and air-bone gap were observed postoperatively.
HRCT identified 2 cases of potential facial nerve prolapse, confirmed intraoperatively.

Conclusions:

HRCT is a valuable tool for preoperative prediction of stapedotomy prosthesis length.
HRCT may assist in identifying prolapsed facial nerves and optimizing surgical planning.
The study suggests HRCT can confirm otosclerosis diagnosis and rule out other abnormalities.