STAPEDOTOMY WITH STAPEDIUS TENDON PRESERVATION - TECHNIQUE AND LONG-TERM RESULTS

From 1975 to 1992, a total of 1459 primary stapedoplasty operations (i .e., stapedectomy, stapedotomy with tendon section, and stapedotomy wi th tendon preservation) were performed in 1323 subjects at the Ear,Nos e, and Throat Department of the University of Verona. Pure-tone audiom etry was carried out in all subjects who were operated on and who unde rwent 6-month and 10-year follow-ups. To evaluate the influence of sta pedius tendon preservation on functional outcome, we randomly selected subgroups of patients using the three different stapedioplasty techni ques and tested them by multiple-frequency tympanometry, psychoacousti c tuning curves, and speech discrimination in noise. Finally, to asses s the effect of prosthesis diameter on middle ear transfer function, w e used the electrocochleographic technique and examined the threshold and latency of cochlear nerve compound action potentials recorded duri ng surgery from the round window. The results of this study show that the best auditory performance in otosclerotic subjects is achieved by performing a stapedotomy of 0.7 mm diameter, using a 0.6 wire-Teflon p iston, and preserving the stapedius tendon.