Malleostapedotomy in stapes revision surgery: is an endoscopic approach possible?

Objectives/Hypothesis: The purpose of the present study was to show our preliminary results regarding the endoscopic ear surgery application in malleostapedotomy surgery. Study Design: Case series. Methods: Six patients (four females and two males) who underwent endoscopic ear surgery as revision surgery for otosclerosis were enrolled in this study. For endoscopic malleostapedotomy surgery, rigid angled endoscopes at 0 ° and 30 ° with a length of 14 cm and an outer diameter of 3 and 4 mm were used. A superelastic nitinol stapes prosthesis was used to connect the malleus neck to the oval window. Results: During endoscopic ear surgery, a lateral ossicular chain fixation was present in all cases. The mean operative time in the study group was 81 minutes (range, 73–89 minutes). A statistically significant difference between preoperative and postoperative hearing findings was observed (P =.007). No cases of sensorineural hearing loss or persistent vertigo were observed in the study sample. No cases of prosthesis displacement or prosthesis extrusion occurred after a mean follow-up of 11.5 months. Conclusions: In 100% of treated cases, the endoscope proved to be adequate for the visualization of the malleus handle and incus, and of their possible abnormalities. Despite the difficulty related to endoscopic single-handed work, none of the surgical steps of endoscopic malleostapedotomy were considered not feasible by endoscopic ear surgery. Level of Evidence: 4. Laryngoscope, 2611–2614, 2018.