IS INCUS TRANSPOSITION WORTRWHILE?
David East, Sunil Dutt
ENT Department, Manor Hospital
WalsallWS29PS,UK
Over a ten year period, 42 incudes were transposed between malleus and stapes head using a standard technique. All transpositions were mechanically stable, and all ears healed satisfactorily.
Indications for surgery were: conductive hearing loss alone (40.4%), cholesteatoma requiring a mastoid cavity (9.5%) and limited cholesteatoma/retraction pocket (50.1%).
Hearing results were generally good; out of 41 ears followed up, 56% showed some improvement, 36.5% no change and in 7.5% the hearing was worse postoperatively.
A Glasgow benefit plot will be used to demonstrate that the number of cases with useful binaural hearing is in fact quite small. The unsatisfactory outcomes are considered to be due to postoperative fibrosis and poor middle ear ventilation.