Stapedotomy for tympanosclerotic stapes fixation: is it safe and efficient? A review of 68 cases.
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.


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


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


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


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


METHODS
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.


CONCLUSIONS
This series demonstrates that safe and successful stapedotomy is possible if certain rules are respected.
Vincent
Robert
R
Jean Causse Ear Clinic, Traverse de Béziers, Clombiers, France. robvinc@aol.com
Oates
John
J
Sperling
Neil M
NM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000502:physiology; D001844:Bone Conduction / Q000502:physiology; D002648:Child; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome