Stapedectomies – 1984 Course
At leading surgical training app SurgSchool’s most emblematic landmarks, the Dr. Emilio García-Ibáñez, an international reference in otology, presents Three classic cases of stapedectomy, one of the most refined surgeries in middle ear microsurgery. This series showcases his personal technique and meticulous anatomical approach to treating otosclerosis.
Surgical approach and local anesthesia
The procedure begins with circumferential anesthesia of the external auditory canal, followed by the creation of a tympanomeatal flap This allows for exposure of the tympanic framework and ossicular chain. This thorough preparation ensures excellent visibility of the oval window niche, reducing risks during manipulation of the stapes footplate.
Obtaining and preparing the perichondrium graft
Dr. García-Ibáñez extracts a wedge of cartilage and perichondrium of the tragus, carefully separating the muscle insertions to preserve tissue integrity.
The graft is thinned especially at the edges until the optimum thickness is obtained for its adaptation to the oval window, playing a key role in sealing and stabilizing the reconstruction.
Exposure of the stirrup and handling of the plate
After completing the atticotomy, the incudostapedial joint and the stapes tendon are exposed. The footplate is drilled in a controlled manner using a decompression puncture, avoiding sudden maneuvers that could cause labyrinthine decompression.
In the cases of obliterative or pseudo-obliterative plates, manual drilling is used to achieve a safe and controlled opening.
Prosthesis placement and ossicular reconstruction
The perichondrium graft is placed over the oval window, and a stapedectomy prosthesis —made of polyethylene or steel—anchored to the anvil. Verification of the mobility of the assembly confirms the functional restoration of the ossicular chain. Finally, the flap is replaced and the duct blockage.
Three different surgical scenarios
Throughout the video, three cases with different anatomical challenges are documented:
- Un deep posterior niche, with limited visibility.
- An extensive otosclerosis, which compromises the mobility of the plate.
- An pseudo-obliterative plate, which requires approach with a manual auger.
Each case exemplifies the need to adapt the technique to the patient's anatomy, always maintaining the microsurgical precision characteristic of Dr. García-Ibáñez.
A training reference for otologists and residents
This series constitutes a essential visual guide For otologists, otoneurologists, and residents interested in otosclerosis surgery. The recordings provide detailed insight into the classic stapedectomy technique, exposure strategies, graft management, and prosthesis placement.
The legacy of Dr. Emilio García-Ibáñez, a pioneer of otological microsurgery in Europe, continues to serve as a teaching and clinical model throughout the world.
Available in the app SurgSchool, the leading online surgical training platform, with internationally recognized surgeries in Otolaryngology, neurosurgery, and interventional radiology. CLICK HERE AND DOWNLOAD THE APP NOW SURGSCHOOL.
