Right otosclerosis revision surgery following previous failed primary operation. The cause of failure was due to a severe dehiscence of the VIIth nerve and the procedure was aborted by the surgeon. During the revision procedure which was performed by Robert Vincent, middle ear exploration confirmed the severe VIIth nerve dehiscence with a simultaneous incus dislocation. The surgery was carried out under facial nerve monitoring. The promontory was carefully drilled out with a 0.7mm diameter diamond dust burr allowing for better and safer exposure of the oval window. The incus was removed and the malleus was relocated. A 0.8mm stapedotomy was drilled out followed by vein graft interposition. Ossiculoplasty was performed with a Hydroxylapatite-Teflon TORP (malleus-to-stapedotomy procedure). Transcanal approach. Dr Robert Vincent, Causse Ear Clinic, Béziers (Colombiers), France
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