Results of stapes operations with preservation of the stapedius muscle tendon.

The material consisted of 195 operated otosclerotic ears. In 101 ears the stapedial tendon was left intact and in 94 ears it was divided. The follow-up period was approximately 8.0 years. The stapedius reflex was tested in 85 ears with intact tendon and in 25 with divided tendon. It was elicited in 50 of the former but in none of the latter. Both bone and air conduction thresholds were postoperatively poorer in ears with preserved tendon than in the ears with divided tendon. Revision surgery was performed in 19 ears, 13 of which had an intact stapedial tendon. The reason for reoperating was usually the fixation of the stapedial crus at the oval window margin. The crus may have shifted because of the pull exerted by the stapedial muscle. In spite of the better circulation to the stapes and the long process of the incus, and of possible protection against loud noises, we cannot, in the light of our experiences, recommend preservation of the stapedius muscle tendon.