Malleus Neck-Anchoring Malleostapedotomy: Preliminary Results

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Abstract

Objective

To compare the hearing outcomes between 2 malleostapedotomy (MS) procedures, handle-MS, connecting the prosthesis with the malleus handle and neck-MS, connecting the prosthesis with the malleus neck.

Patients

Fourteen individuals having undergone MS in the setting of otosclerosis or congenital ossicular fixation from January 1983 through December 2009.

Intervention

Review of preoperative and postoperative audiometric data, ossicular abnormalities, and postoperative complications.

Main Outcome Measures

Postoperative air-bone gap (ABG), closure of ABG, and postoperative changes in bone conduction thresholds.

Results

Of 14 patients, 7 underwent handle-MS, and 7 underwent neck-MS. Morphologic or functional abnormalities of the incus were identified in all cases. There was no significant sensorineural hearing loss. The mean postoperative ABGs were 19.8 ± 11.9 dB in the handle-MS group and 14.7 ± 5.5 dB in the neck-MS group. The postoperative ABGs for single frequencies revealed better results for neck-MS at all frequencies (0.25, 0.5, 1, 2, 3, and 4 kHz) without statistical significance. The functional success rate (ABG closure, ≤10 dB) was 28.6% for the handle-MS group and 42.9% for the neck-MS group (p > 0.05).

Conclusion

Inasmuch as neck-MS is easy to perform and yields comparable results to those of handle-MS, it may be an alternative procedure of use in selected cases of otosclerosis or stapes fixation with incus anomaly.

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