[Technic and spate results of stapedotomy]

The long-term results of 253 stapedotomies and of 444 stapedectomies were compared. Stapedotomy yielded significantly better and more stable results for the higher frequency range (1-4 kHz) than stapedectomy. Reversal of the classic sequence of the surgical steps of stapedectomy has improved the precision of the technique and reduced the possibility of inner ear trauma. Perforation of the footplate and the introduction of the prosthesis into the stapedotomy opening and its crimping to the long process of the incus are performed before separating the incudostapedial joint and removing the stapes arch. For optimal results the 0.4 mm platinum teflon prosthesis should protrude 0.5 mm into the vestibule. If the incus is too short or the oval window niche too narrow the prosthesis is attached directly to the malleus handle, bypassing the incus.