Stapes footplate perforation method: comparison of postoperative hearing outcome

Introduction The perforation of the stapes footplate in the context of a stapesplastiy represents a particular risk potential for the inner ear. The question arises as to how far there are differences in the perforation method.

Material and method Data from patients who underwent implantation of the Codacs™ Direct Acoustic Cochlear Implant System in the Department of Otolaryngology at the Hannover Medical School between September 2009 and February 2018 were analyzed. In the group of patients with a fixed stapes footplate, the Yb:YAG laser was used in 14 cases. In 13 cases, a drill was used to open the stapes footplate. In 6 cases, the stapes footplate was manually opened intraoperatively.

Results Mean bone conduction PTA4 remains constant in patients who received laser or manual perforation. Mean bone conduction PTA4 deteriorates upon drill perforation, although this deterioration has not been significant. With regard to speech intelligibility, the determined p-values show a highly significant improvement in those patients in whom the stapes footplate was perforated using a laser and drill.

Conclusion The methods used to perforate the footplate when inserting a stapes prosthesis are safe and offer the surgeons a selection options that can be choosen from within his existing framework.

Publication History

Article published online:
12 May 2023