Malleostapedotomy for otosclerosis,our experience of nitinol piston on twelve patients  

作　　者：Stephane Gargula Mary Daval Nicolas Arej Mathieu Veyrat Alain Corre Denis Ayache 

机构地区：[1]Department of Otorhinolaryngology,Rothschild Foundation Hospital,Paris,France [2]Clinical Research Department,Rothschild Foundation Hospital,Paris,France

出　　处：《Journal of Otology》2020年第4期129-132,共4页中华耳科学杂志（英文版）

摘　　要：Objective:Malleostapedotomy allows to completely by-pass the incus in otosclerosis surgery.Recently its use has been rivaled by hydroxyapatite cement for cases of mild and moderate necrosis of the incus.However,it remains gold standard for cases of extensive necrosis,incus dislocation,or epitympanic fixation.Modern heat-crimping pistons make surgery easier and safer.This study focuses on our experience with this technique.Methods:Retrospective analysis of patient’s files and pre-and post-operative audiograms,for cases of surgically treated otosclerosis with malleostapedotomy.Results:Twelve patients underwent malleostapedotomy for otosclerosis between 2011 and 2019.Amongst them there were 10 revision surgeries and 2 primary cases.75%had incus long-process necrosis,17%had epitympanic fixation and one had a history of incus transposition.Nine patients(75%)had closure of air-bone gap(ABG)of<10 dB(p<0.001)and 11(92%)had a threshold of 20 dB(p<0.001).Mean pre-operative ABG was 31 dB(15 dBe55 dB),and mean post-operative ABG was 7 dB(0 dBe21 dB;p<0.001).There was no sensorineural hearing loss nor any other post-operative complication.Conclusions:Malleostapedotomy is a safe and reliable technique,allowing an ABG closure comparable to conventional incus to vestibule prosthesis.It remains the preferred technique whenever the incus cannot be used.

关 键 词：MALLEUS STAPES OTOSCLEROSIS Conductive hearing loss Chronic otitis media HYDROXYAPATITE 

分 类 号：R764.9[医药卫生—耳鼻咽喉科]