Endoscopic Malleostapedotomy in Primary Stapes Surgery: Preliminary Results.

Abstract

Objective: To describe the surgical steps in endoscopic malleostapedotomy as a primary intervention and to evaluate the audiologic and surgical outcomes.

Study design: Clinical capsule report.

Setting: University hospital.

Patients: Fourteen patients (10 males and 4 females) who underwent endoscopic malleostapedotomy as a primary intervention between April 2017 and July 2023 were enrolled in this study. Demographic data, surgical information, preoperative and postoperative pure-tone averages and air bone gaps, intraoperative and postoperative complications, and follow-up data were summarized and gathered in a database for further consideration and analysis.

Results: During endoscopic ear surgery, congenital ossicular chain malformation was present in 13 cases and tympanosclerosis in 1 case. The postoperative air-bone gap improved significantly compared with the preoperative gap (18.4 versus 47.4 dB HL, respectively), and the mean air-bone gap closure was 29 dB HL. In 14% of cases, the observed postoperative air-bone gap was less than 10 dB HL, and in 64%, it was between 11 and 20 dB HL. An ABG closure lower than 20 dB HL was achieved in a total of 78% of patients. There was no sensorineural hearing loss or persistent vertigo in the study sample. Two cases of prosthesis too short or prosthesis extrusion occurred after a mean follow-up of 16.9 months.

Conclusions: Endoscopic malleostapedotomy as a primary intervention is a safe and reliable procedure and is a technique of choice in selected cases of stapes fixation with incus anomaly.