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Stapedotomy for Tympanosclerotic Stapes Fixation: Is It Safe and Efficient? A Review of 68 Cases

Vincent, Robert*; Oates, John; Sperling, Neil M.

Otosclerosis
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Objective Performing stapedotomy in cases of tympanosclerotic stapes fixation is controversial. The procedure is traditionally considered to carry a high risk of postoperative sensorineural hearing loss. The aim of this study was to report the hearing results in surgically treated cases of stapes fixation.

Study Design A retrospective review of tympanosclerosis of the oval window with stapes fixation.

Setting The study was performed at the Jean Causse Ear Clinic in Clombiers, France.

Patients Sixty-five patients who underwent surgery for tympanosclerotic stapes fixation between January 1992 and October 1999.

Intervention Stapedotomy with vein graft interposition and reconstruction with a Teflon piston, or a total prosthesis in cases of incudal erosion.

Main Outcome Measures Preoperative and postoperative audiometric evaluation using conventional audiometry. Air-bone gap, bone conduction threshold, air conduction threshold, and Glasgow Benefit Plot were measured.

Results Postoperative air-bone gap closure to within 10 dB was achieved in 39% of cases. An air-bone gap less than 20 dB was obtained in 70% of cases. Significant postoperative improvement of air conduction thresholds, more than 20 dB, was found in 46% of cases. The postoperative bone conduction thresholds were unchanged in 92% of cases. No significant sensorineural hearing loss was seen in this series.

Conclusion This series demonstrates that safe and successful stapedotomy is possible if certain rules are respected.

*Jean Causse Ear Clinic, Traverse de Béziers, Clombiers, France; †Queen's Hospital, Burton upon Trent, UK; and ‡Department of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York, USA

Address correspondence and reprint requests to Robert Vincent, M.D., Clinique Jean Causse, Traverse de Beziers, 34440 Colombiers, France; e-mail: robvinc@aol.com

© 2002 Lippincott Williams & Wilkins, Inc.