Surgery of idiopathic malleus fixation.
OBJECTIVE
To describe and compare 2 different surgical techniques used in treatment of malleus fixation syndrome.


METHODS
A retrospective study including 24 patients (25 ears). In 11 of them, the attical fixation was removed via a transmastoid approach without disruption of the ossicular chain. In 14 patients, an ossiculoplasty was performed via a transcanal approach; the malleus head was removed with the incus, and the ossicular chain was reconstructed either by incus interposition (9 cases) or by using a partial ossicular replacement prosthesis (5 cases). The hearing results were analyzed according to the Committee on Hearing and Equilibrium Guidelines of the American Academy of Otolaryngology.


RESULTS
In the group of attical fixation removed via a transmastoid approach, the preoperative air-bone gap (ABG) attained 25.2 dB, and the postoperative ABG at 1 year followup was 9.1 dB. In the group of ossiculoplasty, the average preoperative ABG reached 26.5 dB, and the postoperative ABG at 1-year follow-up was 8.2 dB.


CONCLUSIONS
There was no statistically significant difference (p = 0.79) between the 2 surgical techniques used to improve hearing in malleus head fixation.
Martin
Cristian
C
ENT Department of the Saint Etienne University Hospital, Saint Etienne, France.
Oletski
Alexander
A
Prades
Jean Michel
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001345:Autoradiography; D001844:Bone Conduction / Q000502:physiology; D002648:Child; D004429:Ear Ossicles / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000209:etiology / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008307:Malleus / Q000002:abnormalities* / Q000601:surgery*; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D010040:Otosclerosis / Q000473:pathology / Q000601:surgery; D013199:Stapes / Q000002:abnormalities; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology / Q000601:surgery