title: Partial promontory technique in stapedotomy cases with narrow niche.
abstract: OBJECTIVE
  The objective of this study was to examine clinical and audiometric outcomes of a laser partial promontory technique in stapedotomy cases with a narrow oval window niche.
  
  
  METHODS
  We conducted a retrospective chart review.
  
  
  METHODS
  This study was conducted at a tertiary referral center.
  
  
  METHODS
  We studied 59 patients who underwent a partial promontory technique with stapedotomy between 1994 and 2000. Seventy-two patients who underwent primary stapedotomy without promontory technique served as a control group.
  
  
  METHODS
  Preoperative and postoperative audiometric results were obtained for 59 patients undergoing laser stapedotomy with a narrow oval window niche. The partial promontory removal was performed with a KTP laser. Results were compared with 72 primary laser stapedotomy cases without the promontory technique within the same time period and analyzed using paired Student t test.
  
  
  RESULTS
  Ninety percent of the partial promontory cases were successful (air-bone gap [ABG] <10 dB). The mean postoperative ABG was 5.1 dB, which was comparable to the non-promontory cases (p = 0.7). The mean change in postoperative bone conduction was also comparable (p = 0.98). There were no cases of sensorineural hearing loss. An overhanging facial nerve was present in 32% of the narrow niche cases and a dehiscent facial nerve was encountered in 17% of these cases.
  
  
  CONCLUSIONS
  Partial laser removal of the promontory as an adjunct to laser stapedotomy cases with a narrow oval window niche is a safe, effective technique with comparable results to primary laser stapedotomy.
authors.affiliation: California Ear Institute, Palo Alto 94303, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Inserra
authors.forename: Theodore P
authors.initials: TP
authors.lastname: Mason
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Yoon
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Roberson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000601:surgery*; D010046:Oval Window, Ear / Q000601:surgery*; D012189:Retrospective Studies; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome