title: Malleostapedotomy: the Marburg experience.
abstract: BACKGROUND
  The surgical procedure for patients with otosclerosis routinely is incus stapedotomy. In case of otosclerosis with incus necrosis or a bony fixation of the malleus and incus, malleostapedotomy is performed.
  
  
  METHODS
  Between May 2002 and September 2003, malleostapedotomy was performed in 6 out of 34 patients with otosclerosis. In 2 primary cases, a middle ear dysplasia was found. The malleus was fixed in 2 further primary cases. Two revision surgeries were performed with incus necrosis present. A titanium piston was used, which was fixed at the malleus handle and introduced into an opening of the footplate.
  
  
  RESULTS
  The preoperative air-bone gap was reduced from 36 dB(A) to 13 dB(A) after surgery for an average checkup time of 3 months. The length of the prostheses varied from 6.3 to 7.5 mm. No patient showed a hearing loss or vertigo after surgery.
  
  
  CONCLUSIONS
  Malleostapedotomy is the technique of choice in case of an additional pathology of the ossicular chain in patients with otosclerosis. Larger numbers of patients and long-term investigations need to compare the results of malleostapedotomy with those of a conventional incus stapedotomy.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Marburg, Germany.
authors.forename: C V
authors.initials: CV
authors.lastname: Dalchow
authors.forename: A A
authors.initials: AA
authors.lastname: Dünne
authors.forename: A
authors.initials: A
authors.lastname: Sesterhenn
authors.forename: A
authors.initials: A
authors.lastname: Teymoortash
authors.forename: J A
authors.initials: JA
authors.lastname: Werner
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone; D001844:Bone Conduction; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000601:surgery*; D006801:Humans; D007188:Incus / Q000601:surgery; D008297:Male; D008307:Malleus / Q000601:surgery*; D008875:Middle Aged; D009998:Ossicular Prosthesis; D010020:Osteonecrosis / Q000601:surgery; D010040:Otosclerosis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D013201:Stapes Surgery / Q000379:methods*; D014025:Titanium
chemical_list: D014025:Titanium