Middle Ear Surgery: Pointers and Pitfalls
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چکیده
It is also important to determine if the malleus is mobile by massaging the tympanic membrane under a Siebel otoscope and microscope. If the malleus is mobile, a normal stapedectomy can be performed, consisting of an incus to oval window prosthesis. This operation has a high rate of success (95%). If the malleus is fixed, however, it is necessary to create a malleus to oval window prosthesis. Because this procedure is harder to perform, the success rate for complete air-bone gap closure declines to about 75%. The failure of surgery may not be due to poor surgical technique but rather to patient selection. A patient who needs a malleus to oval window prosthesis should be cautioned that the operation is not always entirely successful. The air-bone gap of 30 dB may not be closed completely but only reduced to 10 dB.
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