Malleostapedotomy in Patients With Stapes Fixation: A Systematic Review

Objective: To review the literature regarding malleostapedotomy as primary or revision surgery in patients with stapes fixation, to point out the state of the art regarding indications, techniques and outcomes of this procedure. Data Sources: PubMed, CINAHL and Cochrane databases were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Review Methods: Clinical studies describing malleostapedotomy in patients with stapes fixation were included in this Systematic Review. Data about indications, intraoperative findings, features of the prostheses and audiological results were recorded. Results: A total of 25 articles and 632 ears that underwent malleostapedotomy were included in the analysis. This technique has been employed for both primary and revision surgeries, evolving over time alongside advancements in the prostheses used. Revision otosclerosis surgery was identified as the most common surgery necessitating malleostapedotomy. Among the cases, 44.8% achieved ABG closure within 10 dB, while 84.9% achieved ABG closure within 20 dB. Conclusions: Malleostapedotomy is a safe and valid surgical technique that can be performed when incus anchoring stapedoplasty is not feasible.