title: Surgery of isolated malleus fixation due to tympanosclerosis.
abstract: The aim of the present study was to describe our surgical approach for isolated malleus fixation in patients with tympanosclerosis and to analyze the postoperative results. A total of 30 patients presented with isolated malleus fixation were operated. The fixation was reached via canalplasty. Fixated areas were cleaned without damaging the ossicle. Pre- and postoperative audiometric results were evaluated for each patient. Improvement of the pure-tone average (PTA) by at least 10 dB and an air-bone gap (ABG) of less than 20 dB after 12 months of follow-up was accepted to indicate success. The recovery of the postoperative PTA and ABG measurements was significant. Pre- and postoperative PTA was 48.00 ± 11.86 and 24.90 ± 12.45 dB, respectively (p < 0.001). According to PTA measurements, 40-50 dB recovery was achieved in four (13.3 %) patients, 31-40 dB in six (20 %) patients, 21-30 dB in ten (33.3 %) patients, and 11-20 dB in five (16.6 %) patients, with a total success rate of 25/30 (83.2 %). Pre- and postoperative ABG levels were 38.95 ± 9.92 and 16.10 ± 7.79 dB (p < 0.001), respectively. The ABG level was between 0 and 10 dB for 8 (26.6 %) patients, and 11-20 dB for 16 (53.3 %), with a total success rate of 24/30 (80 %). In cases of isolated malleus fixation with tympanosclerosis, performing a canalplasty to clean the sclerotic plaques without damaging the normal anatomy of the ossicle system using a diamond burr is a safe surgical option that provides significant recovery in hearing levels.
authors.affiliation: Department of Otorhinolaryngology, Safa Private Hospital, Istanbul, Turkey. erdalkbb1979@hotmail.com.|, Fevzi cakmak mah. Sisecam bloklari. Emek apt. D:8, Bagcilar, Istanbul, Turkey. erdalkbb1979@hotmail.com.
authors.forename: Erdal
authors.initials: E
authors.lastname: Sakalli
authors.affiliation: Department of Otorhinolaryngology, Safa Private Hospital, Istanbul, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Celikyurt
authors.affiliation: Department of Otorhinolaryngology, Safa Private Hospital, Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Guler
authors.affiliation: Department of Otorhinolaryngology, Bulent Ecevit University Medical Faculty, Zonguldak, Turkey.
authors.forename: Sultan
authors.initials: S
authors.lastname: Biskin
authors.affiliation: Department of Otorhinolaryngology, Devrek State Hospital, Zonguldak, Turkey.
authors.forename: Hasan Deniz
authors.initials: HD
authors.lastname: Tansuker
authors.affiliation: Department of Otorhinolaryngology, Hisar Intercontinental Private Hospital, Istanbul, Turkey.
authors.forename: Selcuk Cem
authors.initials: SC
authors.lastname: Erdurak
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006652:Histological Techniques; D006801:Humans; D008297:Male; D008307:Malleus / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D063371:Myringosclerosis / Q000473:pathology / Q000601:surgery; D013506:Otologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Fixation; Hearing loss; Malleus; Mobilization; Tympanosclerosis