Stapedotomy Removing Only the Stapes Head and Not the Entire Stapes Superstructure: Long-term Results

Objective: To describe a new stapedotomy in which is removed only the stapes head not the entire stapes superstructure and its long-term results. Study Design: Prospective study. Patients: The study was started on January 2015 and ended on September 2020. Seventy patients with otosclerosis were included in the study. They underwent stapedotomy from January 2015 to April 2016. The main follow-up for the study group was (5.1 yrs). The study group was divided into two groups (A and B) according the short hearing results (1 yr) and long hearing results (5.1 yrs). Group A including short hearing results. Group B including long hearing results. For all patients in groups A and B, the surgeon (M.G.), microscope, the anesthesia (local), the approach (transcanal), the prostheses (piston-type), and the new stapedotomy (removal of the stapes head only and not of the entire stapes superstructure), were identical. Results: No patients exhibited postoperative dizziness or worsening of bone conduction. Cutting the stapes neck never caused bleeding or footplate complications. The average time to perform the new stapedotomy was 15 minutes. Air-bone gap (ABG) closure to within 10 dB was achieved in 66 of 70 (94.28%) cases in group A and in 65 of 70 (92.85%) cases in group B. This difference was not statistically significant. Conclusion: The Malafronte's stapedotomy is an easy, safety, minimally invasive, and fast surgical technique. Its hearing outcomes are good and stable over time.