gms | German Medical Science

Introduction: The main techniques used today in stapes surgery are: total stapedectomy, partial posterior stapedectomy and stapedotomy. 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, with a diamond microburr or with the laser beam.

Materials and methods: Between January 2006 and October 2010 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 or with diamond microdrill. 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 aproximatively 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.