A New Reversal Steps Stapedotomy.

Objective: To evaluate whether removal of the stapes head and not the entire stapes superstructure prevents footplate complications.

Study Design: Prospective study.

Patients: One hundred and forty-five patients with otosclerosis were included. Patients were divided into 2 groups as follows: Individuals in group 1 (n = 75) underwent removal of the entire stapes superstructure; individuals in group 2 (n = 70) underwent removal of the stapes head only. These 2 groups were further subdivided into 2 subgroups based on the type of otosclerosis. Group 1a included 55 cases of marginal otosclerosis, while group 1b included 15 diffusive and 5 biscuit otosclerosis cases. Group 2a included 51 marginal otosclerosis cases, while group 2b included 14 diffuse and 5 biscuit otosclerosis cases. Estimations were made regarding statistical correlation between type of reversal steps stapedotomy, otosclerosis type, incidence of footplate complications, and hearing results.

Results: There were 9 footplate complications in group 1b and no complications in group 2b. This difference was significant. Air-bone gap closure to within 10 dB was achieved in 65% of cases in group 1b and 94.7% in group 2b. This difference was significant.

Conclusion: The new stapedotomy prevented footplate complications and improved hearing results in diffuse and biscuit otosclerosis.