Clincal Analysis of Stapedial Fixation with Stapedotomy Surgery

Yoo, Keun Sik; Yoon, Tae Hyun; Choi, Seung Hyo

Abstract

BACKGROUND AND OBJECTIVES: Stapedial fixation is most commonly found in congenital anomaly of middle ear. Congenital middle ear anomaly without anomaly of the auricle and inner ear is rare. The surgery of stapedial fixation has evolved during the last 50 years from total to partial stapedectomy, and finally to stapedotomy. Stapedotomy is less likely to induce iatrogenic inner ear lesions and results in better hearing in the higher frequencies than stapedectomy. In recent years, stapedectomy has increasing tendency to be replaced by stapedotomy. This study was carried out to analyse clinical features of stapedial fixation and evaluate the degree of the auditory improvement, and also to analyse the factors affecting the results after stapedotomy. MATERIALS AND METHOD: From Jan. 1992 to Aug. 2001, we analysed 25 cases (23 patients) of stapedotomy operated by one surgeon for stapedial fixation at Asan Medical Center. The clinical features, preoperative and postoperative audiologic findings, postoperative complication and factors affecting the results were analysed.
RESULTS
Preoperative mean bone and air conduction thresholds were 26.5 dB, 64.0 dB, respectively and mean air-bone gap was 36.5 dB. After stapedotomy, mean bone and air conduction thresholds were 24.9 dB, 37.0 dB, respectively at the last audiologic follow-up. In one case, sensorineural hearing loss was observed. There were no significant differences of results associated with bilaterality, length of piston wire and con-commitent other ossicular anomaly.
CONCLUSION
Stapedotomy is effective and safe for stapedial fixation. But there is a need for carefulness and meticulousness because of complication. There may need various operative trials and larger scale studies to study about factors affecting the results after stapedotomy.