The Loose Areolar Fascia Graft

The graft is cut to a square about 4 x /4 mm, about the size of a cigarette in diameter. It is purposely

Oto-endo pro he

FIGURE 15-5 Laser technique for cutting the posterior crus.

FIGURE 15-6 Laser technique for cutting the anterior crus. Remove the stapes superstructure.

Oto-endo pro he

FIGURE 15-5 Laser technique for cutting the posterior crus.

FIGURE 15-6 Laser technique for cutting the anterior crus. Remove the stapes superstructure.

(Overlap eacN laser hur.it)

Rosette at j tin et ton

Oto-endo probe to create rosette

(Overlap eacN laser hur.it)

Rosette at j tin et ton

Oto-endo probe to create rosette

FIGURE 15—7 Laser technique for creating the rosette on the stapes footplate.

kept very thin, so that it will drape over the promontory and the facial nerve well. The graft is then placed on a glass block with a central hole measuring 1 mm deep and just fitting the size of the shaft of the prosthesis. In this case, it is about 0.8 mm to accommodate a 0.4-mm prosthesis. It is crucial that the graft generously overlaps the vestibule, as this creates a trampoline-like self-centering action for the prosthesis, and any gap may predispose to a

Needle enlarges control hole across footplate

FIGURE 15-8 Manual technique for creating the control hole and dividing the anterior two thirds of the footplate from the posterior one third.

Needle enlarges control hole across footplate

FIGURE 15-8 Manual technique for creating the control hole and dividing the anterior two thirds of the footplate from the posterior one third.

Small hook

FIGURE 15 —9 Remove the posterior one third of the footplate.

Small hook

FIGURE 15 —9 Remove the posterior one third of the footplate.

later perilymph fistula. By drying the graft with a prosthesis in place for a few minutes, the two can easily slip into place. The graft is placed without wetting it, centered over the opening in the footplate, and then the prosthesis is placed in the opening on top of the graft (Fig. 15-11).

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