Next, the posterior crus is removed with the crurotomy
scissor, followed by the removal of the anterior crus with the crurotomy
scissor or by fracture by a downward rotational force with a 2.5mm, 45[degrees] pick introduced between the handle of the malleus and LPI.
Ossicular reconstruction was achieved using a SMart 360 nitinol fluoroplastic piston (Gyrus ACMI, Inc.; Southborough, Mass.), and complete posterior crurotomy was performed with a KTP laser.
This involves either mechanical down-fracture of the superstructure or some degree of crurotomy (division of the posterior and anterior crura of the stapes).
Complete posterior crurotomy was achieved with a KTP laser.
Surgical tips as to how to achieve this include fracturing the superstructure anteriorly rather than inferiorly and, in an already- mobilized stapes, manipulating the angle of the superstructure to allow access to the anterior crus for laser crurotomy.