A New Stapedotomy: Ossicular Chain Bypass With the New Semisynthetic TORP

The study objective is to describe a new stapedotomy and its short-term hearing results.

Prospective study.

Tertiary referral center.

From February to June 2024, was conducted a study on the first 13 total columellar ossiculoplasties with footplate fenestration performed in patients with otosclerosis. In all patients, we used the new semisynthetic TORP (NSSTORP). Its base was positioned on the footplate hole rim, and its head was positioned under the eardrum. The author named this new surgical technique "tympano-stapedotomy." For all patients, the last audiometric control considered was performed on September 2024. The mean follow-up was of 5 months.

Percentage of patients achieving an air-bone gap (ABG) of less or equal to 10 and 20 dB.

At the end of follow-up, the air-conduction pure-tone average (PTA) improved from a mean of 62.1 dB (SD = 18.9) preoperatively to a mean of 42.8 dB (SD = 13.1) postoperatively: an average of 19.3 dB gain. The mean preoperative ABG was 30.9 dB (SD = 9.2), and the mean postoperative ABG was 11.6 dB (SD = 6.4): an average of 19.2 dB gain. The postoperative ABG of ≤10 was achieved in 38.5% (n = 5), of ≤15 in 77% (n = 10), and of ≤20 in 100% (n = 13).

The NSSTORP has a minimal technical challenge for building and placement. The tympano-stapedotomy bypasses the ossicular chain and most of the challenge maneuvers and complications associated with it. Its hearing results are good.