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Pubmed for Handhelds

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  • Title: Malleostapedotomy revisited: the advantages of malleus neck-anchoring malleostapedotomy.
    Author: Park M, Song JJ, Chang MY, Lee JH, Oh SH, Chang SO.
    Journal: Otol Neurotol; 2014 Oct; 35(9):1504-8. PubMed ID: 25076229.
    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. PATIENTS: Thirty-five patients who underwent MS at Seoul National University Hospital from January 1983 to December 2013. INTERVENTION: Review of pre- and postoperative audiometric data, intraoperative findings. MAIN OUTCOME MEASURES: 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). CONCLUSION: 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.
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