Reconstruction of the stapes superstructure when incus is preserved

Introduction In rare cases, the stapes superstructure may be the only missing element in an otherwise intact and healthy middle ear. In these cases, a TORP prosthesis is usually positioned between the stapes foot plate and the eardrum to restore the conductive apparatus, resulting in a tympanoplasty type III. However, this technique unnecessarily bypasses the obtained hammer-anvil joint and, consequently, the function of the normal ossicular chain for adaptation to changes in atmospheric pressure is lost.

Material and methods In 11 patients, the ossicle chain was reconstructed with a TORP between the stapes foot plate and the long anvil leg in an isolated absence of stapes superstructure. The prosthetic plate of the TORP was mechanically bent into a titanium groove.

Results Bone conduction was shown postoperative in all patients idem to preoperative status. With a mean follow-up time of 1.5 years, the conductive component improved by an average of 12 dB (from 27 dB to 15 dB).

Conclusion/Discussion The reconstruction of the sound conduction apparatus with a TORP positioned between the stapes footplate and the incus’ long process and modified on the prosthesis plate is a safe and effective maneuver.

Publication History

Article published online:
12 May 2023