Reducing footplate complications in small fenestra microdrill stapedotomy

Area of Science:

• Otolaryngology
• Neurosurgery
• Surgical Innovation

Background:

• Stapes surgery, specifically stapedotomy, aims to restore hearing by addressing otosclerosis.
• Footplate complications during stapedotomy can negatively impact surgical outcomes and patient hearing.
• Modifications to surgical techniques are explored to mitigate these risks.

Purpose of the Study:

• To identify specific surgical technique modifications in small fenestra stapedotomy that decrease footplate complications.
• To evaluate the impact of these technique changes on postoperative hearing results.

Main Methods:

• Analysis of operative reports from 151 primary stapes surgery patients.
• Data collection on surgical steps, complications, and patient-reported outcomes.
• Comparison of preoperative and postoperative audiograms to assess hearing improvement.

Main Results:

• Fenestrating the footplate after stapes arch removal significantly reduced fractures.
• Fracturing the stapes arch after dividing one crus with a nipper also decreased fracture incidence.
• Microdrill fenestration yielded better hearing results compared to hand drill methods.

Conclusions:

• Specific technical modifications in stapedotomy, including the sequence of fenestration and arch manipulation, are effective in reducing footplate complications.
• The choice of fenestration tool (microdrill vs. hand drill) influences hearing outcomes.
• These findings support technique refinement for improved stapes surgery success.