Assessment of the ability of the radiological incudo-stapedial angle to predict the stapedotomy technique type: a prospective case-series study

• Published in: European archives of oto-rhino-laryngology 2023-11, Vol.280 (11), p.4879-4884
• Main Authors: Barbara, Maurizio, Elzayat, Saad, El-Shirbeny, Hussein A., Salem, Mohammed Abdelbadie, Ebeed, Ahmed I., Covelli, Edoardo, Volpini, Luigi, Margani, Valerio, Elfarargy, Haitham H.
• Format: Article
• Language: English
• Subjects: Head and Neck Surgery; Humans; Incus - surgery; Medicine; Medicine & Public Health; Neurosurgery; Ossicular Prosthesis; Otology; Otorhinolaryngology; Otosclerosis - diagnostic imaging; Otosclerosis - surgery; Prospective Studies; Stapes - diagnostic imaging; Stapes Surgery - methods
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-023-08008-7

Purpose This study aimed to propose a radiological classification of the incudo-stapedial angle by preoperative high-resolution computed tomography (HRCT) images and to highlight its importance for predicting the use of reversal-steps stapedotomy (RSS) rather than the traditional non-reversal technique. Methods We included 83 candidates for stapedotomy operation. Two physicians measured the radiological incudo-stapedial joint angle in the preoperative HRCT. According to this measurement, the radiological incudo-stapedial joint was classified into three types: obtuse, right, and acute. In addition, this radiological classification was correlated with the intraoperative use of the stapedotomy technique, either reversal or non-reversal. Results The RSS technique was used in forty-two (97.7%) cases with an obtuse angle and twenty-six (89.7%) with a right angle. At the same time, the traditional non-reversal technique was used in all patients with an acute angle. The three groups differed significantly regarding the method used for stapedotomy ( P value