title: Malleostapedotomy revisited: the advantages of malleus neck-anchoring malleostapedotomy.
abstract: OBJECTIVE
  To extend our preliminary study by comparing the hearing outcomes of handle-malleostapedotomy (handle-MS; connecting the prosthesis to the malleus handle) and neck-MS (connecting the prosthesis to the malleus neck) in a larger case series.
  
  
  METHODS
  Thirty-five patients who underwent MS at Seoul National University Hospital from January 1983 to December 2013.
  
  
  METHODS
  Review of pre- and postoperative audiometric data, intraoperative findings.
  
  
  METHODS
  Postoperative air-bone gap (ABG) and closure of ABG.
  
  
  RESULTS
  In 11 of 20 patients (55.0%) in the handle-MS group and 12 of 15 (80%) in the neck-MS group, the postoperative ABG closed to within 20 dB HL. For frequencies of 0.25, 0.5, 1, 2, 3, and 4 kHz, the ABGs did not differ significantly between the two groups. The postoperative ABG closure was lower in the neck-MS group (22.3 ± 12.6 dB HL) than in the handle-MS group (23.5 ± 11.6 dB HL), but without statistical significance (p = 0.78). Four patients in each group underwent MS as a revision procedure. One of them underwent neck-MS as revision surgery because of prosthesis extrusion after handle-MS. The mean ABG closure at 1 year postoperatively in patients who underwent revision neck-MS (19.9 ± 11.9 dB HL) was not different from that of the patients who underwent revision handle-MS (20.9 ± 8.7 dB HL).
  
  
  CONCLUSIONS
  As neck-MS provided results comparable to those of handle-MS in our extended case series, it might be a useful procedure in selected cases of otosclerosis or stapes fixation with an incus anomaly, especially in revision cases after handle-MS.
authors: *Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea; †Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; and ‡Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Korea.
authors: Mina
authors: M
authors: Park
authors: Jae-Jin
authors: JJ
authors: Song
authors: Mun Young
authors: MY
authors: Chang
authors: Jun Ho
authors: JH
authors: Lee
authors: Seung Ha
authors: SH
authors: Oh
authors: Sun O
authors: SO
authors: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001299:Audiometry; D001844:Bone Conduction; D002648:Child; D004427:Ear Diseases / Q000601:surgery*; D005260:Female; D006309:Hearing; D006314:Hearing Loss, Conductive / Q000601:surgery; D006320:Hearing Tests; D006801:Humans; D007188:Incus / Q000601:surgery; D008297:Male; D008307:Malleus / Q000601:surgery*; D008875:Middle Aged; D019736:Prostheses and Implants; D066106:Seoul; D013201:Stapes Surgery / Q000295:instrumentation* / Q000379:methods*; D055815:Young Adult