Abstract
The surgical technique of stapedotomy using an artificial piston after removing the superstructure of stapes for otosclerosis has prevailed for more than 50 years. During the procedure, an unexpected stapedectomy or floating footplate that may impair the function of the inner ear sometimes occurs. To avoid the risk of inner ear complications, a novel stapes surgery technique was developed.
The concept of the novel technique of stapes surgery is to remove the lenticular process of incus instead of removing the superstructure of the stapes to restore the conduction of the ossicular chain. A Schuknecht Teflon wire piston is then inserted into the small fenestra of the footplate passing between the crus of stapes.
Since 2004, 48 cases have undergone this surgery. Among the 48 cases, 40 cases followed for more than one year were evaluated. The results of average air conduction hearing gain were 18.9 dB, and the number of cases of air-bone gap closure of 20 dB or less was 36 （90％） while the hearing acuity remained stable for over five years.
In conclusion, this novel stapes surgery that preserves the stapes is an easy, safe and timesaving technique.
