Malleostapedotomy in stapes revision surgery: Is an endoscopic approach possible?

Iannella, Giannicola; Angeletti, Diletta; Manno, Alessandra; Pasquariello, Benedetta; Re, Massimo; Magliulo, Giuseppe

doi:10.1002/lary.27206

Cited by 12 publications

(12 citation statements)

References 19 publications

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“…A close analysis of the incus and accurate evaluation of the extent of necrosis requires excellent visualization of the ossicular chain. Similarly, malleostapedotomy requires detailed visualization and inspection of the oval window and lateral ossicular chain; the endoscopic approach has been applied in this setting and shown to be effective in a small case series . Notably, the cause of surgical failure was accurately diagnosed with imaging in one of three patients who had preoperative CT scans; however, conclusions regarding the utility of preoperative CT scans cannot be drawn from this small sample size.…”

Section: Discussionmentioning

confidence: 99%

Audiologic and surgical outcomes in endoscopic revision stapes surgery

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Audiologic and surgical outcomes in endoscopic revision stapes surgery

et al. 2019

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“… 5 , 6 , 7 However, current research on endoscopic stapes surgery is limited to traditional incudostapedotomy despite the fact that malleostapedotomy can be performed entirely using an endoscope alone, as demonstrated by Iannella et al in six revision stapes surgery cases. 8 To date, this is the only clinical study on endoscopic malleostapedotomy (EMS). Moreover, no studies have compared the surgical outcomes of EMS and endoscopic incudostapedotomy (EIS).…”

Section: Introductionmentioning

confidence: 99%

Endoscopic malleostapedotomy versus incudostapedotomy for stapes fixation with or without lateral chain fixation: A comparative outcomes study

Son,

Moon,

Sung

et al. 2024

Laryngoscope Investig Oto

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ObjectivesThis study aims to evaluate and compare the surgical outcomes of endoscopic malleostapedotomy (EMS) and endoscopic incudostapedotomy (EIS).MethodsA retrospective analysis was conducted on 36 consecutive ears in 33 patients who underwent stapes surgery using either EMS (EMS group) or EIS (EIS group). Operational practicability across surgical steps, postoperative hearing, operation time, switch of approach, and complications were compared between the two groups.ResultsThe EMS and EIS groups comprised seven (19.4%) and 29 ears (80.6%), respectively. The EMS group exhibited a greater proportion of moderate practicability in anchoring site exposure (42.9%, three of seven) and in securing the prosthesis (100%, seven of seven) in comparison to the EIS group, which had 0% (0 out of 29) and 41.4% (12 out of 29), respectively. Postoperative hearing improvements were equivalent between the groups, with EMS achieving a mean air‐bone gap improvement of 28.8 dB and EIS of 23.2 dB. The ABG closure rates within 10 dB and 20 dB for the EMS group were 28.6% and 100%, respectively, and not significantly different from the EIS group (p = .103). However, the average surgical duration for EMS was extended by 77.4 min. The rate of complications was comparable between the groups (EMS 14.3%, EIS 10.3%, p = 1.000).ConclusionThe findings indicate that while EMS requires a longer operation time because of decreased practicability in specific surgical steps, it provides comparable outcomes to EIS, underscoring the potential of endoscopic techniques to establish malleostapedotomy as a surgical option as it is with traditional incudostapedotomy.Level of Evidence4.

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“…M alleostapedotomy (MS), also known as malleovestibulopexy or malleus grip stapedotomy, is an otologic procedure in which the prosthesis is attached to the malleus on one end and the stapes footplate on the other end. This procedure was first introduced by Fisch et al 1,2 Malleostapedotomy is performed mainly in revision cases where the lateral ossicular chain is fixed, for management of advanced tympanosclerosis involving the oval window and for cases of eroded incus. 1,2 Like any other surgery, MS has its own challenges including selection of the appropriate prosthesis which will have a significant impact on MS success.…”

mentioning

confidence: 99%

“…This procedure was first introduced by Fisch et al 1,2 Malleostapedotomy is performed mainly in revision cases where the lateral ossicular chain is fixed, for management of advanced tympanosclerosis involving the oval window and for cases of eroded incus. 1,2 Like any other surgery, MS has its own challenges including selection of the appropriate prosthesis which will have a significant impact on MS success. In a temporal bone dissection study, they have found that the average distance should be 6.3 mm between the site of MS crimp and stapedotomy site (range: 5.75-7.0 mm).…”

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The role of malleostapedotomy in intra-operative incus injury

Alabdulqader

Hajr

2021

SMJ

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dDÃ« jÐ-sLC²¹ Ê-_« VÞ w -uD²¹ ¡«dł≈ u¼ ©MS® rEFÃ« oý Ê‫إ‬ •dDÃ« vKŽ WOÐUÂdÃ« ÂbIÃ« W×OH Ë 5 dDÃ« bŠ√ sÄ WÁdD*UÐ wŽUMD ô« 5²OKLFÃ 5²ÃUŠ ÂbI½ AE…d³šË «-UNÄ VKD²ðË …oebF²Ä wŽ«Ëoe UNÃ AEdšü« WOÐdFÃ« WJKL*« ¨÷U¹dÃ« ¨Ê-úÃ wBB ²Ã« tKÃ« b³Ž pK*« eÂdÄ® U½eÂdÄ w MS Â«b ²Ý« -Ë ¨ WOŠ«d'« WOKLFÃ« ¡UMŁ√ WÐU ≈ XŁbŠ YOŠ ©W¹oeuF Ã« v{-w WOÃUŽ ZzU²½Ë WŠ«d'« bFÐ …bOł ZzU²MÐ WOLEFÃ« WK K Ã« ¡UMÐ …oeUŽù sÄ b¹bFÃ« qCH¹ AEÎ ö¹uÞ U Î ²ÁË ‚dG² ðË U Î OŠ«dł W³F WOKLFÃ« Ê_ i¹d*« s¹cÃ« 5Š«d'« lOLł Ê√ bI²F½ ¨pÃ-lÄË AEUNÐ ÂUOIÃ« ÂbŽ Ê-_« wŠ«dł w WI¦Ã« «u³ ²J¹Ë W¹«-oe vKŽ «u½uJ¹ Ê√ »UÂdÃ« WLEŽ WŠ«dł lÄ ÊuKÄUF²¹ w²Ã« UHŽUC*« bŠ√ u¼ WOKLFÃ« ¡UMŁ√ Ê«bM Ã« lKš Ê√ vÃ≈ Î «dE½ MS ¡«dł≈ AEb¹bAÃ« -c(« lÄ v²Š Àb% Ê√ sJ1Malleostapedotomy (MS) is an evolving otology procedure that involves attaching prosthesis to the malleus on one end and the stapes footplate on the other end. It has multiple indications and requires skills and experience. We present 2 cases operated in our center (King Abdullah Ear Specialist Center, Riyadh, Saudi Arabia) in which intraoperative incus injury occurred, and MS was used to reconstruct the ossicular chain with good postoperative outcomes and patient satisfaction. As the procedure was surgically difficult and time consuming, many otologists prefer not to do it. Nevertheless, we believe that all surgeons dealing with stapes surgery should be familiar and gain confidence in performing MS considering that intraoperative incus dislocation is a complication that can happen even with great caution.

show abstract

Malleostapedotomy in stapes revision surgery: Is an endoscopic approach possible?

Abstract: 4. Laryngoscope, 2611-2614, 2018.

Cited by 12 publications

References 19 publications

Audiologic and surgical outcomes in endoscopic revision stapes surgery

Audiologic and surgical outcomes in endoscopic revision stapes surgery

Endoscopic malleostapedotomy versus incudostapedotomy for stapes fixation with or without lateral chain fixation: A comparative outcomes study

The role of malleostapedotomy in intra-operative incus injury

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