The discrimination scores remained unchanged. Audiometric testing of five cases with one year follow-up demonstrates that excellent hearing results are maintained. In selected cases of minimal otosclerosis confined to the fissula antefenestrum, normal mobility of the ossicular chain can be obtained without a prosthesis by vaporizing the anterior crus and making a linear stapedotomy across the anterior one-third of the footplate. The advantages of the procedure are that the stapedius tendon and most of the normal stapes remain intact, eliminating hyperacusis. The procedure is less invasive reducing inner ear trauma, possible prosthesis problems are avoided, and postoperative barotrauma risk is minimized.
Minimal surgery is done for minimal disease.
If the stapes refixes at some time in the future, a conventional stapedotomy can still be performed. This suggests that it may be worthwhile to preserve the cochlear nerve in certain patients who may otherwise be candidates for labyrinthectomy. Patients were given 3.0 mg melatonin taken nightly for 30 days followed or proceeded by a placebo nightly for 30 days, with a 7-day washout period in between. The average pre-treatment THI score was 33.91 as compared to 26.43 after the placebo and 26.09 after melatonin. The difference in the THI scores between melatonin and placebo were not statistically significant.