Manubrio-stapedioplasty: new surgical technique for malleus and incus fixation due to tympanosclerosis

Objective:This paper reports the authors' technique of manubrio-stapedioplasty using glass ionomer cement for malleus and incus fixation due to tympanosclerosis.Methods:A retrospective case review was conducted of five patients with conductive hearing loss (mean pre-operative air–bone gap of 42.75 dB) treated in a tertiary referral centre. The hearing results of a manubrio-stapedial bone cement ossiculoplasty technique, utilised on the five patients, were analysed. All cases were Wielinga and Kerr tympanosclerosis classification type 2 (attic fixation of the malleus-incus complex with a mobile stapes). The incus and head of the malleus were removed in all patients, and the manubrium was directly connected to the head of the mobile stapes using glass ionomer cement. Patients were evaluated in terms of pre- and post-operative audiometric results; hearing gain and post-operative air–bone gap were the main outcome measures.Results:Mean post-operative air–bone gap was 5.25 dB. Four patients had an air–bone gap of less than 10 dB; the remaining patient had an air–bone of 12.50 dB.Conclusion:Manubrio-stapedioplasty is an effective method for ossicular reconstruction in cases of malleus and incus fixation due to tympanosclerosis.