Linear transmission between malleus and stapes in cases with incus necrosis.

OBJECTIVE: The outcome of cartilage interposition ossiculoplasty was assessed in cases of incus necrosis after posterior malleus repositioning in the plane of the stapes, in terms of hearing gain after ossicular reconstruction. METHODS: A retrospective observational study was conducted of 30 patients admitted to an Ain Shams University hospital from March 2021 to September 2021. All patients with ossicular disruption due to chronic suppurative otitis media and hearing loss of more than 40 dB were included in the study. Pure tone audiometry was conducted for each patient after three months, six months and one year post operation. RESULTS: The audiogram showed a post-operative air-bone gap of 20 dB or less in 83.33 per cent of patients (n = 25) at three months post-operatively and in 80 per cent of patients after six months; after one year, the results remained the same. CONCLUSION: The use of cartilage interposition after malleus posterior mobilisation represents an excellent partial ossicular replacement technique.

Tratamiento de la patología del complejo incudomaleolar combinada con fijación del estribo mediante maleoestapedotomía / Malleostapedotomy in the pathology of the incudomalleolar complex combined with fixation of the stapes

Introducción: La fijación del estribo combinada con trastornos del complejo incudo-maleolar requiere una reconstrucción de la transmisión del sonido, que, a menudo, resulta difícil de resolver. Esta situación puede presentarse en diversas patologías u observarse en revisiones de estapedectomía. Pacientes y métodos: Presentamos nuestra experiencia de cuatro pacientes en los que hemos realizado una maleoestapedotomía, con eliminación del ligamento anterior y la apófisis anterior del mango del martillo. Resultados: Comentamos los hallazgos observados en cada uno de los casos, previos a la realización de la técnica. En dos casos se consiguió un cierre del umbral diferencial audiométrico, mientras en los otros dos se obtuvo una mejoría auditiva sin cierre completo. Discusión: Exponemos las distintas causas que pueden originar la hipomovilidad del martillo y del yunque. Realizamos una revisión de la literatura sobre los resultados obtenidos mediante esta técnica en revisiones de estapedectomía

Introduction: Stapes fixation combined with disorders of the incudo-malleolar complex disorders requires a sound transmission reconstruction that often is difficult to solve. This circumstance can turn up in several pathologies and also in revision surgery for otosclerosis. Patients and methods: We present our experience with four patients that underwent to malleostapedotomy with removal of the malleus anterior ligament and the malleus anterior apophysis. Results: We discuss the previous findings in each case. Two patients reached a gap closure and the other two patients obtained an auditive gain without complete gap closure. Discussion: We set out the ethiology of malleus and incus hipomobility. We do a bibliographic review on the results of this technique in revision stapedectomy