Tympanoplasty Type IV Using a Y-shaped Ceramic with Unintentionally Mobilized Footplate during Surgery for Otoscierosis

Abstract

Sixty-six cases diagnosed with otosclerosis underwent small fenestra stapedotomy in our clinic. During surgery, the stapes footplate became mobile in 6 cases, so-called “floating stapes”. Considering the risk of sensorineural hearing loss, we chose tympanoplasty type IV placing a Y-shaped ceramic between the incus and the footplate, rather than stapedectomy.
Improvement of the hearing level was evaluated by the standard of the Otological Society of Japan as the improvement of the hearing level. The success rates of hearing improvement were 100%. There were no cases showing progressive sensorinual hearing loss. Postoperative vertigo occurred in only one case and was very mild.
The stapes is fractured not infrequently or becomes mobile during surgery for otosclerosis in Japan. In order to avoid the risk of sensorineural hearing loss due to perilymph leakage following stapedectomy, the method that we used in the present series was considered one of the good options under these circumstances, However we consider that recurrence of hearing loss due to refixation of the stapes is possible in the future.