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Stapedotomy for tympanosclerotic stapes fixation: Is it safe and efficient? A review of 68 cases

Otology and Neurotology, ISSN: 1531-7129, Vol: 23, Issue: 6, Page: 866-872
2002
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Objective: Performing stapedotomy in cases of tympanosclerotic stapes fixation is controversial. The procedure is traditionally considered to carry a high risk of postoperative sensorineural hearing loss. The aim of this study was to report the hearing results in surgically treated cases of stapes fixation. Study Design: A retrospective review of tympanosclerosis of the oval window with stapes fixation. Setting: The study was performed at the Jean Causse Ear Clinic in Clombiers, France. Patients: Sixty-five patients who underwent surgery for tympanosclerotic stapes fixation between January 1992 and October 1999. Intervention: Stapedotomy with vein graft interposition and reconstruction with a Teflon piston, or a total prosthesis in cases of incudal erosion. Main Outcome Measures: Preoperative and postoperative audiometric evaluation using conventional audiometry. Air-bone gap, bone conduction threshold, air conduction threshold, and Glasgow Benefit Plot were measured. Results: Postoperative air-bone gap closure to within 10 dB was achieved in 39% of cases. An air-bone gap less than 20 dB was obtained in 70% of cases. Significant postoperative improvement of air conduction thresholds, more than 20 dB, was found in 46% of cases. The postoperative bone conduction thresholds were unchanged in 92% of cases. No significant sensorineural hearing loss was seen in this series. Conclusion: This series demonstrates that safe and successful stapedotomy is possible if certain rules are respected.

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