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.