gms | German Medical Science

Introduction: The main techniques used today in stapes surgery are: stapedectomy (under 10%), partial posterior stapedectomy (small fenestra technique) and stapedotomy (more than 90%). The advantages of stapedotomy are: less trauma to the inner ear and a better stability of the prosthesis. The stapedotomy opening can be made with manual perforators, diamond microburr, laser beam or skeeter drill.

Materials and methods: Between January 2006 and October 2011 a total of 162 patients were operated in the ENT Department of the University of Medicine and Pharmacy Timisoara, performing 183 procedures. We used titanium stapes prostheses of 0.4–0.6 mm diameter and 4.5, 4.75 mm lengths. The stapedotomy was performed with the manual perforators (majority of the cases) or with diamond microdrill (sometimes). 17 out of 162 patients were bilateral operated (10.49%). 15 out of 183 procedures were surgical revisions (8.19%).

Results: A postoperative air-bone gap of 0–10 dB was obtained in approximatively 90% of the cases. A partial sensorineural hearing loss, only on high frequencies, occurred in one patient (0.62%). Postoperative vertigo was rare and of short duration.

Conclusion: The stapedotomy technique produces little trauma to the inner ear and good functional results. Titanium stapes prostheses have maximum biocompatibility, small weight, the most superior mechanical properties, such as elasticity, stability and stiffness.

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