title: Incus replacement malleostapedotomy in quiescent chronic otitis media with a mobile stapes footplate: an alternative to TORP in select cases.
abstract: OBJECTIVE
  To review the results of malleostapedotomy for incus replacement in the setting of quiescent chronic otitis media and a mobile stapes footplate and to discuss the potential application for this technique in select cases.
  
  
  METHODS
  Seven individuals having undergone malleostapedotomy in the setting of quiescent chronic otitis media and a mobile stapes footplate between 2004 and 2009.
  
  
  METHODS
  Review of surgical results and hearing outcomes as measured by preoperative and postoperative pure-tone audiometry.
  
  
  METHODS
  Closure of preoperative air-bone gap and change in preoperative versus postoperative pure-tone bone conduction thresholds.
  
  
  RESULTS
  Improvement in air-bone gap was noted in 6 of 7 subjects with an average closure of 17 dB. In 5 of 7 subjects, the air-bone gap was closed to 20 dB or less, and in 3 of 7 subjects, the air-bone gap was closed to 10 dB or less. No significant changes in postoperative bone conduction pure-tone average thresholds were noted. No immediate or delayed complications were encountered over an average follow-up time of 23.6 months (range, 5-42 mo).
  
  
  CONCLUSIONS
  Although the data are limited by the small sample size, malleostapedotomy seems to be a potentially safe and effective alternative to placement of a total ossicular replacement prosthesis in properly selected specialized instances of quiescent chronic otitis media. Further study is recommended to more definitively establish the safety and efficacy of this technique.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA. michaelgluth@mac.com
authors.forename: Michael B
authors.initials: MB
authors.lastname: Gluth
authors.forename: Shahpar
authors.initials: S
authors.lastname: Motakef
authors.forename: Peter L
authors.initials: PL
authors.lastname: Friedland
authors.forename: Marcus D
authors.initials: MD
authors.lastname: Atlas
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone; D001844:Bone Conduction / Q000502:physiology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007188:Incus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009998:Ossicular Prosthesis; D010033:Otitis Media / Q000601:surgery*; D013506:Otologic Surgical Procedures; D013200:Stapes Mobilization / Q000379:methods*; D013201:Stapes Surgery / Q000379:methods*; D016896:Treatment Outcome