Restoration of Columellar Effect Using a Teflon Piston in Otosclerosis Surgery: Anatomo-Clinical, Endoscopic and Radiological Correlation in a Case Report

Objective: To describe the anatomical, iconographic, and functional aspects of a case of otosclerosis surgery optimized under unconventional video-endoscopic control. Clinical Observation: A 27-year-old male patient was admitted for progressive unilateral right-sided conductive hearing loss of 5 years’ duration, in the context of a normal tympanic membrane. Preoperative audiometry revealed a significant air-bone gap at conversational frequencies with preserved cochlear reserve. Impedance audiometry showed a slight decrease in tympano-ossicular system compliance with an absent stapedial reflex. Preoperative computed tomography revealed a stapes footplate thickening of approximately 0.7 mm associated with hypodensity of the antefenestram fissula on the right. A stapedotomy was performed endoscopically. The postoperative course was uneventful, with mild vertigo and transient tinnitus in the first 24 hours. There was no dysgeusia or facial paralysis. A postoperative audiometric examination performed after three months noted the closure of the air-bone gap (Air-Bone Gap) of less than 10 dB. Computed tomography (CT) of the temporal bones performed after 6 months shows perfect radio-opacity of the implant.