Modified stapes surgery for otosclerosis - An evaluation of auditory results and postoperative complications

Q: What was the purpose of refining the minimally traumatic stapes surgery technique?

The study aimed to assess whether a refined MTSS approach improves hearing outcomes and lowers postoperative complications in patients with otosclerosis.

Q: How were postoperative auditory results evaluated?

Audiometric outcomes were assessed by comparing pre- and postoperative air conduction thresholds, air–bone gaps, and bone conduction thresholds.

Q: What postoperative complications were observed after MTSS?

Only a few complications occurred, including vertigo, chorda tympani injury, facial weakness, and slight hearing deterioration.

Sep 29, 2026

Uploaded by Levi

Refined minimally traumatic stapes surgery (MTSS) is evaluated in patients with otosclerosis to determine whether the modified technique improves hearing and reduces postoperative problems. Medical records of individuals undergoing MTSS were reviewed, with outcomes including audiometric changes and newly developed complications. In 106 affected ears, air conduction thresholds and air–bone gaps improved significantly, while bone conduction showed no meaningful change. Complications were uncommon, supporting MTSS as a hearing-promoting approach with minimal morbidity.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Introduction

Otosclerosis and risks of stapes surgery

Rationale for minimally traumatic stapes surgery (MTSS)

Abstract

Background

Methods

Results

Conclusion

J Chin MedAssoc Original article Modified stapes surgery for otosclerosis: An evaluation of auditory results and postoperative complications Chih-En Changa, Ivy Yenwen Chaua, Yu-Hsien Liua, An-Suey Shiaoa,b,c,* aDepartment of Otolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan, ROC; bFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; cDepartment of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Abstract Background: The senior author Shiao, had introduced a modified version of the traditional stapes surgery, called minimally traumatic stapes surgery (MTSS), and explored its effectiveness in reducing postoperative vertigo. However, MTSS exhibited no significant breakthrough in terms of audiometric results. Building upon the original MTSS through slight modifications and the use of the Medtronic Big Easy® Piston as the prosthesis, this study evaluates a refined version of the original MTSS technique. In particular, this research sought to investigate the impact of this refined approach on hearing outcomes and postoperative complications among patients diagnosed with otosclerosis. Methods: This research comprehensively examined the medical records of individuals diagnosed with otosclerosis who underwent MTSS. The postoperative outcomes assessed encompassed hearing outcomes and the occurrence of any new complications. Results: Overall, 95 patients diagnosed with otosclerosis (comprising 106 affected ears) underwent MTSS. Significant improvements in both the average air conduction threshold (40 ± 16.82 dB after vs 60 ± 14.56 dB before surgery; p < 0 .0001) and average air–bone gap (11 .99 ± 7.24 dB after vs 29.65 ± 9.47 dB before surgery; p = 0 .003) were observed after the surgery. Conversely, no significant change in the average bone conduction threshold was observed after the procedure (28 ± 13.81 dB after vs 29 ± 12.31 dB before surgery; p = 0. 149) . Among the 106 affected ears, 102 showed postoperative air–bone gap measurements <20 dB, indicating an impressive 96.2% overall hearing improvement. Notably, only a few postoperative complications were observed, including vertigo, chorda tympani injury, facial weakness, and a slight hearing deterioration. Conclusion: The refined MTSS technique promoted significant postoperative hearing improvements with minimal complications. This approach showed potential for addressing the surgical challenges in Asian patients with otosclerosis, emphasizing the importance of further research on this advanced procedural method. Keywords: MTSS; Otosclerosis; Stapes surgery 1. INTRODUCTION Otosclerosis is an inherited condition that causes conductive or mixed-type hearing loss due to abnormal bone growth in the middle ear, mainly affecting the stapes, and bony labyrinth. Incidence rates of this condition are higher among Caucasians (0.3%-1.2%) than Asians (0.006%-0.5%) .1–3 Although stapes surgery can improve hearing outcomes, it has been associated with certain risks, such as total sensorineural hearing loss (1% of cases), tinnitus, vertigo, dysgeusia, facial palsy, and hearing deterioration.4–11 Moreover, stapes surgery requires a high level of skill given its steep learning curve. Surgeons practicing *Address correspondence. Dr. An-Suey Shiao, Department of Otolaryngology, Cheng Hsin General Hospital, 45, Cheng Hsin Street, Taipei 112, Taiwan, ROC. [E-mail address: asshiao@gmail.com](E-mail address: asshiao@gmail.com) (A.-S. Shiao). Conflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article. Journal of Chinese Medical Association. (2024) 87: 728-733. Received August 8, 2023; accepted March 6, 2024. doi: 10. 1097/JCMA.0000000000001107 Copyright © 2024, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.or

FAQs

What was the purpose of refining the minimally traumatic stapes surgery technique?

The study aimed to assess whether a refined MTSS approach improves hearing outcomes and lowers postoperative complications in patients with otosclerosis.

How were postoperative auditory results evaluated?

Audiometric outcomes were assessed by comparing pre- and postoperative air conduction thresholds, air–bone gaps, and bone conduction thresholds.

What postoperative complications were observed after MTSS?

Only a few complications occurred, including vertigo, chorda tympani injury, facial weakness, and slight hearing deterioration.

Sep 29, 2026

Uploaded by Levi