Compared with total stapedectomy for otosclerosis, small fenestra stapedotomy with a piston prosthesis is currently preferred mainly because it:

• A Reduces the risk of postoperative sensorineural hearing loss ✓
• B Gives a larger air-bone gap closure in every case
• C Eliminates the need for a tissue seal around the prosthesis
• D Allows surgery without opening the middle ear

Explanation

Stapedotomy creates a small controlled fenestra in the footplate, preserving vestibular integrity better than total stapedectomy. This lowers the incidence of dead ears, serous labyrinthitis, perilymph gusher complications and prosthesis migration into the vestibule, so the risk of postoperative sensorineural hearing loss falls. Hearing results are comparable rather than uniformly superior, and the middle ear is still opened with a tissue or blood seal still needed around the piston.

Reference: Scott-Brown's Essential Otorhinolaryngology, 2nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.