Stapes fixation caused conductive hearing loss can be restored by mechanical reconstruction of the mobility of the sound-transmitting ossicular system. The evolution of the surgical treatment in stapes fixations optimized the visualization of the oval window niche. Sealing the vestibule by different types of grafting materials, e.g., vein, fascia, connective tissue, fat, and gelfoam, leads to calibrating the predictable hearing improvement gain more precisely. Substance of the stapes prosthesis and the piston followed important changes from polyethylene toward biocompatible ceramics, Teflon wire, gold, titanium, and stainless steel. The size of the opening into the vestibule is decreased from total stapedectomy to partial stapedectomy and then to a hole of different size between 0.4 and 0.8 mm (stapedotomy). The controversial issues related to stapedectomy (total removal of the stapes footplate) or stapedotomy (making only a hole in the footplate) are hearing in the speech frequencies (0.5 to 1-2 kHz), hearing in the high frequencies (4 and 8 kHz), stability of hearing, postoperative vertigo/unsteadiness, and tinnitus.
ASJC Scopus subject areas
- Biochemistry, Genetics and Molecular Biology(all)