Maleovestibulopexy with Vincent total prosthesis
El Dr. José Carlos Casqueiro, renowned otorhinolaryngologist and expert endoscopic surgeon at the Severo Ochoa Hospital in Madrid, has recently shared an educational video through the Surgical training app SURGSCHOOL. In this video, Dr. Casqueiro performs a maleovestibulopexy using the total prosthesis Vincent, in a patient with congenital conductive hearing loss caused by incus malformation and associated partially obliterative otosclerosis.
Malleovestibulopexy with repositioning of the malleus handle is an innovative procedure devised by the Dr Robert Vincent to solve hearing loss caused by alterations of the ossicular chain. In this specific case, the patient has a malformation of the incus, one of the three small bone structures in the middle ear that are essential for the proper transmission of sound. In addition, partially obliterative otosclerosis further complicates the situation, affecting the mobility of auditory structures.
Surgery steps
The surgical technique employed by Dr. Casqueiro involves several meticulous steps. First of all, a careful Dissection of the tympanic membrane from the malleus handle, a crucial structure in sound transmission in the middle ear. This dissection will allow its repositioning, towards a more favorable situation for sound transmission.
Once the malformation of the incus is exposed, the surgeon proceeds to removal, to gain access to the last ossicle and the platen, the door to the inner ear. This step is essential to restore proper hearing function and ensure optimal sound transmission through the middle ear.
The central part of the surgery involves the placement of Vincent's total prosthesis on a vein graft, which acts as a sealant for the platen and facilitates fixation of the prosthesis. This graft provides stability and ensures that the prosthesis stays securely in place, which is essential for the long-term success of the procedure.
The choice of total prosthesis Vincent It is a strategic decision by Dr. Casqueiro. This prosthesis offers specific features that make it ideal for this type of surgery, including its ability to adapt to different anatomies and its design that ensures optimal sound transmission.
