During stapedectomy for otosclerosis, a 'floating footplate' occurs. What is the most appropriate next step?
- A Abort the procedure immediately and close the middle ear
- B Perform a stapedotomy through the floating footplate using a laser and proceed with prosthesis ✓
- C Remove the footplate piecemeal using picks and proceed with prosthesis placement
- D Use a fine needle to aspirate perilymph and remove the footplate in one piece if possible
Correct answer: B. Perform a stapedotomy through the floating footplate using a laser and proceed with prosthesis
Explanation
A 'floating footplate' during stapedectomy is best managed by creating a small stapedotomy through the now-mobile footplate using a laser or fine pick, then placing the prosthesis through this opening. Attempting to remove the floating footplate in toto risks perilymph loss and displacement into the vestibule. Aborting surgery is not necessary if the procedure can be completed safely.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.