Compared with total stapedectomy, small fenestra stapedotomy for otosclerosis offers which principal advantage?

• A Greater closure of the air-bone gap at low frequencies
• B Better preservation of the chorda tympani
• C Elimination of the need for a prosthesis
• D Lower incidence of postoperative sensorineural hearing loss and perilymph fistula ✓

Explanation

Stapedotomy creates a controlled fenestra of roughly 0.5 to 0.8 mm in the footplate, usually with a laser or microdrill, and seats a piston within it. Because the vestibule is opened minimally, perilymph loss, vestibular reaction and dead ear from inner ear injury are markedly less frequent than after removing the whole footplate. Air-bone gap closure is comparable between techniques, a prosthesis is still required, and the chorda tympani is at equal risk in both approaches.

Reference: Scott-Brown's Otorhinolaryngology Head and Neck Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.