The Markham-Stouffville hospital experience with malleovestibulopexy.

OBJECTIVE

To analyze the hearing results of malleovestibulopexy (MVP) technique in the special situations encountered in revision stapedotomies and congenital middle ear malformations.

DESIGN

Retrospective chart review.

SETTING

Tertiary referral stapes surgery center, community hospital.

METHODS

Audiometric results of 1369 stapedotomies performed in Markham-Stouffville Hospital during a period from 1991 to 2006 were reviewed. The results of 24 MVP procedures employed for revision stapedotomy or for congenital conductive hearing loss were included.

MAIN OUTCOME MEASURES: Air-bone gap (ABG) closure, air conduction (AC) gain, speech reception threshold (SRT) improvement.

RESULTS

Significant improvement in AC, ABG and SRT was demonstrated postoperatively. ABG closure within 20 dB was achieved in 61% of cases. One patient had transient postoperative vertigo. None of patients developed sensori neural hearing loss (SNHL) due to the surgery.

CONCLUSION

When surgical options for middle ear reconstruction are limited due to stapes immobility combined with absent or eroded incus, MVP offers a useful alternative enabling good hearing results. In our experience, the laser-assisted MVP technique is associated with low risk of postoperative SNHL and vestibular symptoms. This method offers a valuable adjunct to standard middle ear reconstruction techniques.