Stapedectomy

In 1995, Glasscock et al. published a 25-year single-centre review of over 900 patients who underwent stapedectomy and stapedotomy and found complications rates as follows: reparative granuloma 1.3%, tympanic membrane perforation 1.0%, total sensorineural hearing loss 0.6%, partial sensorineural hearing loss 0.3%, and vertigo 0.3%.

[6] A modified stapes operation, called a stapedotomy, is thought by many otologic surgeons to be safer and reduce the chances of postoperative complications.

[5] Laser stapedotomy is a well-established surgical technique for treating conductive hearing loss due to otosclerosis.

The procedure creates a tiny opening in the stapes (the smallest bone in the human body) in which to secure a prosthetic.

The CO2 laser allows the surgeon to create very small, precisely placed holes without increasing the temperature of the inner ear fluid by more than one degree, whilst decreasing the risk of footplate fracture, making this an extremely safe surgical solution.

Treatment can be completed in a single operation visit using anesthesia, normally followed by one or two nights' hospitalization with subsequent at-home recovery time a matter of days or weeks.

[16] In 1999, Professor Tarabichi described his experience with stapedotomy performed using the endoscope without the need for bone removal or skin incision (endaural approach).

[17] Professor Patel and his Australian team published a relatively large cohort of patients undergoing endoscopic stapedotomy procesure with closure of air-bone gape within 20 dB in 98.6%.

[19] Significant contributions to modern stapedectomy techniques were then made by the late Dr. Antonio De La Cruz of the House Ear Institute in Los Angeles; by the late Professor Henri André Martin of the Hôpital Edouard Herriot in Lyon, France, including calibrated platinotomy (stapes footplate rather than whole surgery) and trans-footplate piston surgery that also paved the way for modern stapedotomy;[20] and by the late Dr. Jean-René Causse of the eponymous clinic in Béziers, France, who pioneered the use of Teflon piston prostheses (also critical progress for stapedotomy) and, with his late son Dr. Jean-Bernard Causse, the reattachment of the stapedius muscle alongside the use of veinous grafts.

Endoscopic view of the stapedotomy in the footplate of the stapes bone
Endoscopic view of the piston inserted into the stapedotomy and on to the long processof the incus