title: From incus bypass to malleostapedotomy: technical improvements and results.
abstract: OBJECTIVE
  To assess results of malleostapedotomy using a Fisch Storz titanium piston with at least 10 months' follow up.
  
  
  METHODS
  Using a prospective database, the indications, surgical technique, and pre- and post-operative audiometric data for 60 patients undergoing malleostapedotomy between 2002 and 2010 were evaluated. Diagnoses and primary and revision surgeries were compared with reference to the literature.
  
  
  RESULTS
  Sixty endaural malleostapedotomies were performed, 28 as a primary intervention and 32 as revision surgery. In 68 per cent, the underlying pathology was otosclerosis. The most common reason for revision surgery (i.e. in 59 per cent) was prosthesis dysfunction. Overall, the mean air-bone gap (0.5-3 kHz) for the primary intervention and revision surgery groups was 9.4 and 11.3 dB, respectively; an air-bone gap of less than 20 dB was obtained in 100 and 81 per cent of patients, respectively. There was no significant audiological difference between the primary and revision surgeries groups, and no deafness.
  
  
  CONCLUSIONS
  Malleostapedotomy shows comparable results to standard incus-stapedotomy and may be preferable in the presented situations.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, Kantonsspital Luzern, Lucerne, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Rambousek
authors.forename: C H
authors.initials: CH
authors.lastname: Schlegel
authors.forename: T E
authors.initials: TE
authors.lastname: Linder
mesh_terms: D001299:Audiometry; D002648:Child; D002675:Child, Preschool; D005260:Female; D006314:Hearing Loss, Conductive / Q000601:surgery; D006801:Humans; D007188:Incus / Q000601:surgery*; D007223:Infant; D008297:Male; D008307:Malleus / Q000601:surgery*; D009998:Ossicular Prosthesis; D010040:Otosclerosis / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D013201:Stapes Surgery / Q000295:instrumentation / Q000379:methods*; D014025:Titanium
chemical_list: D014025:Titanium