Stapedectomy modified by the application of fibrin tissue adhesive.

Certain failures of the stapes operation are caused by loosening of the crimped metal loop on the long process of the incus, atrophy or necrosis of the lenticular process, erosion of the long process with the prosthesis causing injury to the labyrinth, erosion of the incudostapedial joint with upward rotation of the long process, and dislocation of the prosthesis. To reduce the occurrences of these failures following stapes removal, we close the oval window by gluing a fascia graft into place with fibrin tissue adhesive. A ceramic strut with a cup on its upper end that fits the lenticular process is glued between the fascia graft and the lenticular process. This method does not cause bone necrosis or blood circulation disturbances. The hearing results are the same or better than those reported for other stapes procedures.