Results: Audiometric evaluation showed a maximal unilateral left conductive hearing loss. High resolution temporal bone CT showed absence of the oval window on the left along with facial and stapes abnormalities. Exploratory tympanotomy showed an aberrant facial nerve, monopodal and abnormally located stapes and absent oval window. Postoperative hearing gain achieved after a neo-oval window and...

Among the many existing hearing problems, there are those that need to be corrected through the replacement of the ossicles of the middle ear with a prosthesis. The type of the prosthesis used in the rehabilitation of the middle ear, total ossicular replacement prosthesis (TORP) or a partial ossicular replacement prosthesis (PORP) depends of the level of the ossicular impairment [1,2]. In the p...

OBJECTIVE Use of the SMart piston, a nitinol-based, self-crimping prosthesis in stapes surgery may allow improved functional results because of better sound transmission properties at the incus-prosthesis interface because of the elimination of manual crimping. Possible disadvantages include thermal damage or strangulation of the incus and its mucoperiosteum or nickel intolerance. The goal of t...

Piston stapes prostheses are implanted in patients with refractory conductive or mixed hearing loss due to stapes otosclerosis to stimulate the perilymph with varying degrees of success. The overclosure effect described by the majority of researchers affects mainly low and medium frequencies, and a large number of patients report a lack of satisfactory results for frequencies above 2 kHz. The m...

INTRODUCTION One of the most difficult and time-consuming steps in malleostapedotomy surgery is the crimping of the prosthesis onto the malleus handle manually. The advent of the nitinol prosthesis (Gyrus nitinol piston [GNP]; Gyrus ENT LLC, Bartlett, TN) significantly reduced the difficulty of this surgical step, rendering its fixation to the malleus easy and fast. However, Kwok et al. analyze...

OBJECTIVES Two steps in stapedotomy are particularly challenging: (1) micropick fenestration of the stapes footplate (SF) and (2) crimping of the stapes prosthesis (SP) to the incus. We conducted trials to determine if experience correlates with differences in performance for these tasks. METHODS In a surgical model of stapedotomy, performance was measured for 3 experienced and 3 novice surge...

Congenital middle ear malformations are rare. Most part of them are usually associated with other malformations, such as aural atresia, microtia, and dysmorphic craniofacial features. A clinical case of a 24-year-old male with a right-sided conductive hearing loss since his childhood, without craniofacial malformation, is presented. He was proposed for exploratory tympanotomy under the suspicio...

OBJECTIVE To describe the technique used for total ossiculoplasty with the Fisch titanium total prosthesis and evaluate the 1-year postoperative functional results in patients presenting with the stapes (or footplate) without the malleus handle. STUDY DESIGN Prospective trial with preoperative and postoperative comparison. SETTING Academic and private practice tertiary care center for otolo...

In a prospective study, 165 total stapedectomies and 152 small fenestra stapedotomies were performed by three experienced surgeons between 2001 and 2003. In total stapedectomy, a self-made Schuknecht steel wire connective tissue prosthesis, and in stapedotomy, a 0.6-mm platinum wire Teflon piston was used. The pre- and postoperative bone conduction thresholds were compared at the frequencies 25...