Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T05:00:02.315Z Has data issue: false hasContentIssue false

Outcome of malleo-stapedotomy using the malleus relocation technique during revision stapes surgery

Published online by Cambridge University Press:  05 November 2010

M R Ghonim
Affiliation:
Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Egypt
Y K Shabana*
Affiliation:
Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Egypt
M Y Elkotb
Affiliation:
Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Egypt
*
Address for correspondence: Dr Yousef K Shabana, 38 Bank Misr St, Mansoura, 35111, Egypt Fax: 002 0107366997002 (050) 2267016 E-mail: [email protected]

Abstract

Objective:

This study aimed to use a new otological technique, malleus relocation, to solve the problems of ossicular reconstruction undertaken during revision stapes surgery for incus necrosis.

Study design:

Prospective study of 12 patients undergoing revision stapedectomy for incus necrosis, in the otolaryngology department of Mansoura University, Egypt.

Patients and methods:

Twelve patients underwent ossiculoplasty between June 2004 and June 2007, as part of revision surgery for otosclerosis with incus necrosis. All patients underwent ossiculoplasty using the malleus relocation technique. Ossiculoplasty used the patient's own, necrosed incus between the relocated malleus and the footplate.

Results:

Post-operative air–bone gap closure to within 10 dB was achieved in seven patients (58.3 per cent). An air–bone gap of less than 20 dB was obtained in 10 patients (83.3 per cent). Deterioration of bone conduction by 10 dB occurred in one case. No patients were left with a ‘dead ear’. Patients’ hearing was stable throughout the follow-up period (range six to 40 months; mean ± standard deviation 23.5 ± 12.8 months).

Conclusion:

These findings indicate that malleus relocation, performed during revision stapes surgery, is a safe and efficient technique for the treatment of incus necrosis.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Lundy, LB. Otosclerosis update. Otolaryngol Clin North Am 1996;29:841–51CrossRefGoogle ScholarPubMed
2Farrior, J, Sutherland, A. Revision stapes surgery. Laryngoscope 1991;101:1155–61Google Scholar
3Applebaum, EL. A hydroxyapatite prosthesis for defect of the incus long process. Laryngoscope 1993;103:330–2CrossRefGoogle ScholarPubMed
4Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. American Academy of Otolaryngology–Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 1995;113:186–7Google Scholar
5Silverstein, Y, Bendet, E, Rosenberg, S. Revision stapes surgery with and without laser: a comparison. Laryngoscope 1994;104:1431–8Google Scholar
6Magliulo, G, Cristofari, P, Terranova, G. Functional hearing results in revision stapes surgery. Am J Otol 1997;18:408–12Google ScholarPubMed
7Vlaming, MS, Feenstra, L. Studies on the mechanics of the reconstructed human middle ear. Clin Otolaryngol 1986;11:411–22Google Scholar
8Vincent, R, Oates, J, Sperling, NM, Annamalai, S. Malleus relocation in ossicular reconstruction: managing the anteriorly positioned malleus: results in a series of 268 cases. Otol Neurotol 2004;25:223–30CrossRefGoogle Scholar
9Feldman, BA, Schuknecht, HA. Experiences with revision stapedectomy procedures. Laryngoscope 1970;80:1281–91CrossRefGoogle ScholarPubMed
10Lippy, WH, Schuring, AG. Solving ossicular problems in stapedectomy. Laryngoscope 1983;93:1147–50CrossRefGoogle ScholarPubMed
11Pearman, K, Dawes, JD. Poststapedectomy conductive deafness and results of revision surgery. J Laryngol Otol 1982;96:405–10Google Scholar
12Lippy, WH, Schuring, AG. Stapedectomy revision of the wire Gelfoam prosthesis. Laryngoscope 1983;91:913Google Scholar
13Lippy, WH, Schuring, AG. Prosthesis for the problem incus in stapedectomy. Arch Otolaryngol 1974;100:237–9CrossRefGoogle ScholarPubMed
14Farrior, J, Sutherland, A. Revision stapes surgery. Laryngoscope 1991;101:1155–60CrossRefGoogle ScholarPubMed
15Kisilevsky, VE, Bailie, NA, Dutt, SN, Halik, JJ. Hearing results of stapedotomy and malleo-vestibulopexy in congenital hearing loss. Int J Pediatr Otorhinolaryngol 2009;73:1712–17CrossRefGoogle ScholarPubMed