* m malleus handle * t TM * i incus * s superstructure of stapes * f footplate of stapes * v vestibule (no distinction is made between footplate perforation, footplate removal, or placement of a soft tissue graft, although these differences may be recorded for presenting/reporting on the dataset) * d direct coupling of TM without a graft or prosthesis (e.g., [O.sub.sd] is myringostapediopexy) iii.
* [O.sub.sd] Flat cartilage graft used in TM reconstruction in contact with stapes (cartilage myringostapediopexy)
We performed myringostapediopexy
in 20 patients using autologous incus, myringoplatinopexy in 3 cases using autologous malleus and type 1 tympanoplasty in rest of the patients using autologous temporalis fascia.
Naturally occurring myringostapediopexy frequently results in minimal hearing loss and is asymptomatic.
A previous study conducted by our group found that 53% of the patients with myringostapediopexy (defined by Costa et al (5) as a retraction limited to the postero-superior region, in which there is erosion of the long process of the incus and fixation of the affected TM to the head of the stapes) presented with an air-bone gap [less than or equal to] 25 dB at all frequencies.
Still, the decision of how, and especially when, to intervene surgically in a patient with a dry myringostapediopexy should take into consideration at least three important clinical aspects, and the functional result is only one of them.
At the same sitting, myringostapediopexy
was performed using autologous incus and temporalis fascia (Fig.
During postoperative follow-up, the patient was noted to have a shallow retraction with a myringostapediopexy (figure).
Myringostapediopexy, a term popularized by Juers, (1) is also known as a type III tympanoplasty in the Wullstein classification.
Otoscopic examination of the right ear revealed an atelectatic tympanic membrane with myringostapediopexy
This represents a myringostapediopexy. The short process of the malleus is the white structure at the top of the photograph.
Myringostapediopexy, when it occurs naturally, can be stable and function well.