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Is the Prosthesis Length in Malleostapedotomy for Otosclerosis Revision Surgery Predictable?

Kaftan, Holger*; Böhme, Andrea; Martin, Heiner

doi: 10.1097/MAO.0000000000000448

Hypothesis The prosthesis length in malleostapedotomy for otosclerosis revision surgery can be calculated if the prosthesis length of previous conventional incus stapedotomy is known.

Background Malleostapedotomy is used in revision surgery for otosclerosis in case of severe incus erosion and malleus or incus fixation.

Methods Fifteen cadaveric human temporal bone specimens were investigated by means of micro-CT followed by 3D analysis. The distance between the incus and the stapes footplate as well as distances between the malleus and the footplate were measured and compared.

Results The required length of virtually bent prostheses corresponded approximately to the 1.5-fold of virtual stapes prostheses in 93%. The addition of 2 mm predicted the required prostheses length almost correctly in 80%.

Conclusion The clinical practice will show whether a preoperative calculation of expected prosthesis length in MS based on the length of the formerly used stapes prosthesis is possible and helpful.

*Department of Otorhinolaryngology and Head and Neck Surgery, University of Greifswald, Greifswald, Germany; and †Institute for Biomedical Engineering, University of Rostock, Rostock, Germany

Address correspondence and reprint requests to Holger Kaftan, M.D., Department of Otorhinolaryngology and Head and Neck Surgery, University of Greifswald, Walther-Rathenau-Str. 43-45, 17475 Greifswald, Germany; E-mail:

The authors disclose no conflicts of interest.

Copyright © 2014 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company