Otosclerosis With Concomitant Anterior Malleolar Ligament Fixation

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Otosclerosis is a pathological temporal bone remodeling that affects the otic capsule. The prevalence of this condition is 0.3% among Caucasians, with a male:female ratio of 1:2 (1). Otosclerosis affects the stapes footplate, causing conductive hearing loss. More severe cases involve the cochlear endosteum, which can add a sensorineural component to the hearing loss. Treatment via surgical intervention consists of stapedotomy, with an approximate success rate of 90% (2). Displacement of the prostheses, whether due to incus erosion and/or expulsion of the piston from the vestibule, is typically responsible for most of the failures. However, undetected concurrent malleus fixation may account for 0.8 to 4.0% of these failures, with anterior malleus ligament fixation being the most common source (3,4).

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