In a review of 137 patients who underwent surgery for otosclerosis, in 46 patients (33.6%) a laser STAMP procedure was performed.9 In all of these cases, there was a blue footplate with fixation confined to the anterior portion. Intraoperative success was determined by verifying mobility of the posterior footplate with palpation of the ossicles.9 Of these 46
FIGURE 17-2 Cut the anterior crus.
patients, only three have required reoperation for conversion from a laser STAMP procedure to a traditional stapedotomy procedure with use of a prosthesis. Sixteen patients (11.7%) were initially thought to be laser STAMP candidates and underwent attempted laser STAMP procedures, but were converted intraoperatively to a stapedotomy with prosthesis insertion.9 The most common cause of failure was unrecognized fixation of the posterior footplate, which became evident intraoperatively when the stapes remained fixed following the laser STAMP procedure. In 57 patients (41.6%), a laser STAMP procedure was not attempted secondary to extensive otosclerosis.9
A review of clinical outcomes in 46 patients with greater than a 4-month follow-up shows the average 6-week postoperative air—bone gap was closed from 22 dB [standard deviation (SD) 10 dB, range 8 to 49 dB] to 6 dB (SD 4 dB, range 0 to 14 dB).9 For the most recent audiograms, the average long-term air—bone gap observed was 5 dB (SD 6 dB, range 0 to 23 dB, average follow-up 25 months). The average discrimination score remained stable at 95% preoperative, 95% at 6 weeks, and 96% for the latest audiograms.9
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