Transmembranous piston extrusion after stapedotomy: A rare complication

Abstract

To report an adverse event after successful otosclerosis surgery: piston extrusion through the tympanic membrane, and its surgical solution. Four patients with a history of stapes surgery in context of otosclerosis presented with recurrent conductive hearing loss due to piston extrusion. Otoscopy, audiometric assessment and CT-imaging were conducted to assess the encountered conductive hearing loss and extrusion of the prosthesis. Revision stapes surgery was performed with interposition of cartilage between tympanic membrane and piston-loop. Pre- and postoperative audiometry and otoscopic evaluation. Revision surgery resulted in postoperative ABG within 15 dB. No recurrent extrusion was seen after the mentioned surgical procedure including use of cartilage graft. In case of piston extrusion (trans-tympanic membrane), revision stapes surgery with interposition of a cartilage layer between tympanic membrane and piston is advocated to prevent recurrence.

Keywords:

• Piston extrusion
• stapedotomy
• otosclerosis
• transmembranous

Ethics statement

This study was conducted according to international medical ethical standards and in compliance with the WMA Helsinki declaration (2016) and International Ethics; Local Ethical Board number 21/713.

Patient consent

Patients’ approval for the mentioned data is collected.

Disclosure statement

No potential conflict of interest was reported by the author(s).