title: Obliquity of the stapes in otosclerosis: intra-operative observations and implications in stapes surgery.
abstract: OBJECTIVE
  To establish the prevalence of stapes obliquity as observed in otosclerosis patients during stapes surgery by a simple method of intra-operative measurement.
  
  
  METHODS
  Prospective observational study.
  
  
  RESULTS
  Intra-operative measurements showed that the mean distance (± standard deviation) between the horizontal segment of the facial nerve and stapes crura in 10 cases of otosclerosis was 0.74 mm (± 0.21 mm), whereas in 10 cases of non-otosclerosis the same distance was 0.20 mm (± 0.00). There was no gap (0 mm) between the stapes crura and inferior border of the oval window niche in otosclerotic ears, whereas in non-otosclerotic ears the same distance was 0.13 mm (± 0.05 mm). The differences were statistically significant (p < 0.0001).
  
  
  CONCLUSIONS
  Obliquity and downward displacement of the stapes occurs in otosclerosis. It has diagnostic value as a new clinical sign in otosclerosis. The findings correlate with late complications and failures in stapes surgery. Methods to avoid these have been suggested.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery,MCV Memorial ENT Trust Hospital,Pollachi,Tamil Nadu,India.
authors.forename: V
authors.initials: V
authors.lastname: Anand
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery,MCV Memorial ENT Trust Hospital,Pollachi,Tamil Nadu,India.
authors.forename: H N
authors.initials: HN
authors.lastname: Udayabhanu
mesh_terms: D016022:Case-Control Studies; D005154:Facial Nerve / Q000473:pathology; D006801:Humans; D010040:Otosclerosis / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D013199:Stapes / Q000473:pathology*; D013201:Stapes Surgery / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Anatomy; Otosclerosis; Stapes