(A814) Endocopic Malleostapedotomy in Primary Stapes Surgery: Preliminary Results

Introduction: Malleostapedotomy is a technically challenging otologic procedure, and endoscopic malleostapedotomy was only sporadically described in stapes revision surgery after prior stapedotomy.The aim of this study is to assess audiological and surgical outcomes in a cases of fourteen patients who underwent endoscopic malleostapedotomy as primary surgery.

Methods: Fourteen patients (Ten males and four females) who underwent endoscopic malleostapedotomy as a primary intervention in the Second Affiliated Hospital of Xi'an Jiaotong University between April 2017 to July 2023 were enrolled in this study. Demographic data, surgical information, preoperative and postoperative pure tone averages and air bone gaps, intraoperative and postoperative complications and follow-up data were summarized and gathered in a database for further consideration and analysis.

Results: During endoscopic ear surgery, congenital ossicular chain malformation was present in thirteen cases, and tympanosclerosis in one case. The postoperative air–bone gap improved significantly compared to the preoperative gap (18.4 vs 47.4 dB HL, respectively), and the mean air–bone gap closure was 29 dB HL. In 14 % of cases, the observed postoperative air–bone gap was less than 10 dB HL and in 64 % it was between 11 dB HL and 20 dB HL. An ABG closure lower than 20 dB HL was achieved in a total of 78 % of patients. There was no sensorineural hearing loss or persistent vertigo in the study sample. Two cases of prosthesis too short or prosthesis extrusion occurred after a mean follow-up of 16.9 months.

Conclusions: Endoscopic malleostapedotomy as a primary intervention is a safe and reliable procedure and is a technique of choice in selected cases of stapes fixation with incus anomaly.