[Malleostapedotomy in stapes surgery for otosclerosis with malleus/incus mobility disorder].

OBJECTIVE: To evaluate the feasibility, safety and effectiveness of malleostapedotomy based on malleus-oval window technique in otosclerosis with malleus/incus mobility disorder. METHOD: Six cases with malleostapedotomy on stapes footplate fixation accompanied by malleus/incus movements disorder from March 2005 to March 2007 were analyzed retrospectively, when totally 78 cases of conventional stapes surgeries were performed on isolated otosclerosis . The surgical procedures, intraoperative findings and postoperative vertigo as well as pure tone gain were discussed. RESULT: All of the 6 cases showed stapes footplate fixation. Both abnormal incudomalleolar joint and incudostapedial joint were found in 2 cases. It was suspected that previous inflammation resulted in yellowish mucosa, ossicular malformation and stiffness. The third one showed local tympanosclerosis in the attic. In another 2 cases, idiopathic malleus head fixation related to the anterior and superior mallear ligament abnormal were presented while a surgical incudomalleolar joint dislocation prior to the observation happened in the last one. Among these 6 cases, there was no 4.0 Hz notch and postoperative vertigo which needs a further care. Postoperative air-bone gap on 0.5 kHz, 1.0 kHz, 2.0 kHz, 4.0 kHz averaged less than 10 dB. All the patients had been followed up for 3 months. CONCLUSION: Malleostapedotomy based on malleus-oval window technique is a safe and effective procedure available for otosclerosis with malleus/incus movement disorder from different origins.