Incus replacement malleostapedotomy in quiescent chronic otitis media with a mobile stapes footplate: an alternative to TORP in select cases.

Abstract

OBJECTIVE:

To review the results of malleostapedotomy for incus replacement in the setting of quiescent chronic otitis media and a mobile stapes footplate and to discuss the potential application for this technique in select cases.

PATIENTS:

Seven individuals having undergone malleostapedotomy in the setting of quiescent chronic otitis media and a mobile stapes footplate between 2004 and 2009.

INTERVENTION:

Review of surgical results and hearing outcomes as measured by preoperative and postoperative pure-tone audiometry.

MAIN OUTCOME MEASURES:

Closure of preoperative air-bone gap and change in preoperative versus postoperative pure-tone bone conduction thresholds.

RESULTS:

Improvement in air-bone gap was noted in 6 of 7 subjects with an average closure of 17 dB. In 5 of 7 subjects, the air-bone gap was closed to 20 dB or less, and in 3 of 7 subjects, the air-bone gap was closed to 10 dB or less. No significant changes in postoperative bone conduction pure-tone average thresholds were noted. No immediate or delayed complications were encountered over an average follow-up time of 23.6 months (range, 5-42 mo).

CONCLUSION:

Although the data are limited by the small sample size, malleostapedotomy seems to be a potentially safe and effective alternative to placement of a total ossicular replacement prosthesis in properly selected specialized instances of quiescent chronic otitis media. Further study is recommended to more definitively establish the safety and efficacy of this technique.

• Authors: Michael B Gluth, Shahpar Motakef, Peter L Friedland, Marcus D Atlas
• Journal: Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology (Otol Neurotol) Vol. 32 Issue 2 Pg. 242-5 (Feb 2011) ISSN: 1537-4505 [Electronic] United States
• PMID: 21150689 (Publication Type: Journal Article)

Topics

• Adult
• Audiometry, Pure-Tone
• Bone Conduction (physiology)
• Chronic Disease
• Female
• Humans
• Incus (surgery)
• Male
• Middle Aged
• Ossicular Prosthesis
• Otitis Media (surgery)
• Otologic Surgical Procedures
• Stapes Mobilization (methods)
• Stapes Surgery (methods)
• Treatment Outcome