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Updated: Jan 28, 2026

The Microscopic Transcanal Approach in Stapes Surgery Revisited
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Stapes Prosthesis Length: One Size Fits All?

Holger Sudhoff1, Hans Björn Gehl2, Ercan Boga2

  • 1Department of Otolaryngology, Head and Neck Surgery, Klinikum Bielefeld, Academic Hospital: Ruhr Universität Bochum, Bielefeld, Germany.

Audiology & Neuro-Otology
|February 21, 2019
PubMed
Summary
This summary is machine-generated.

Individual stapes prosthesis length measurement ensures optimal insertion depth, avoiding complications. Standard lengths risk improper placement and potential bony contact within the vestibule during stapedotomy.

Keywords:
Insertion depthOtosclerosisProsthesis length

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Biomedical Engineering

Background:

  • Successful stapedotomy relies on proper stapes piston insertion into the vestibule.
  • Current clinical practices involve either individualized prosthesis length measurement or using a standard length.
  • The choice of prosthesis length handling impacts surgical outcomes and patient safety.

Purpose of the Study:

  • To compare individualized versus standard stapes prosthesis length measurement methods.
  • To evaluate the effect of these methods on the prosthesis insertion depth.
  • To assess the risk of complications associated with different prosthesis length strategies.

Main Methods:

  • Retrospective analysis of 39 stapedotomy patients.
  • Radiological estimation of vestibular stapes prosthesis insertion depth.
  • Hypothetical adjustment of individual measurements to standard lengths (4.75-5.5 mm) for comparison.

Main Results:

  • Individualized measurements resulted in a mean insertion depth of 0.74 mm (0.2-1.6 mm) with a mean insertion depth/vestibular depth ratio of 26.6%.
  • Standard lengths led to varied vestibulum positions and potential bony contact at the vestibule floor.
  • The ratio of insertion depth to vestibular depth varied significantly (8-59.1%) with standard lengths.

Conclusions:

  • Individualized stapes prosthesis length measurement is crucial for achieving optimal insertion depth.
  • This method resulted in a zero rate of problematic vestibulum positions and low insertion depth/vestibular depth ratios.
  • Standard prosthesis lengths may increase the risk of malpositioning and complications during stapedotomy.