Incus & Malleostapedotomy
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2025-03-08
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Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery
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University of Cape Town
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Abstract
Stapedotomy refers to the calibrated fenestration of a fixed footplate and insertion of a prosthesis. Prof Ugo Fisch first introduced the terms incusstapedotomy where the prosthesis is attached to the long process of the incus, vs. malleostapedotomy where the prosthesis is attached to the malleis handle. The surgical steps of both procedures will be described as per Prof Ugo Fisch. Otosclerosis is the most common indication for stapedotomy. Histology of temporal bone specimens show that there may be a fairly high incidence (up to 30%) of additional malleal fixation in otosclerosis. Hyalinisation and ossification of the anterior malleal ligament are related to the duration of otosclerosis. Fixation of the malleus head and incus body is usually found in narrow external ear canals. The reported incidence of malleal fixation in clinical studies varies significantly for both primary (0.6 - 6%) 3,4 and revision surgery (3-37%).5,6 In a study (unpublished data) conducted by the senior author (T.L), the incidence was found to be 5% with primary surgery.
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Reference:
Harris, T. & Linder, T. 2025. Incus & Malleostapedotomy. In Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery. J. Fagan, Ed.Cape Town, South Africa: University of Cape Town. 17. http://hdl.handle.net/11427/43488 .