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We present a case of a highly unusual stapes in the presence of a normal external ear. The stapes exhibits rudimentary anterior crus with abnormally shaped posterior crus that attached to the mid-portion of a fixed, rudimentary footplate. To our knowledge, this anomaly has not been previously documented. We review the embryological cause that may be contributing to the development of this congenitally abnormal stapes superstructure. This is to highlight the importance of the knowledge of the anatomy of the stapes and its variations especially to the otologists.

Objective: To determine the long-term control of sialorrhea in children who underwent submandibular duct rerouting (SMDR) and to identify potential preoperative predictors of outcome. Design: Retrospective chart review of children who underwent SMDR; information updated by discussion with the permanent caregiver. Setting: Tertiary care center. Patients: Children who had significant sialorrhea resulting from a variety of neuromuscular disabilities between January 1980 and December 1995. Outcome: We report the outcome on 59 patients who underwent SMDR for the treatment of sialorrhea. Patients were ascribed a preoperative sialorrhea and global neurologic deficit score. Postoperative outcome was scored as marked, moderate, no improvement, or worse. Twenty-eight of 59 (47.4%), 28 of 59 (47.4%), and 3 of 59 (5.1%) of the patients had preoperative sialorrhea scores of 3 (profuse), 2 (moderate), and 1 (mild), respectively. Twenty of 59 (33.9%), 29 of 59 (49.2%), and 10 of 59 (16.9%) had preoperative scores of 3 (severe), 2 (moderate), and 1 (mild) neurologic impairment, respectively. Mean time to follow-up of the 59 patients was 5.46 years. Postoperative improvement scores were as follows: 50.8% had marked, 28.8% had moderate, and 20% had no to minimal improvement in their sialorrhea. Two patients were transiently worse. A complication rate of 11.3% (9 of 79) was demonstrated: 7 ranulae, 1 transient swelling of the floor of the mouth, and 1 submandibular gland infection. The preoperative global neurologic deficit score was found to be more predictive of surgical outcome than sialorrhea score. (Otolaryngol Head Neck Surg 1999;120:303-7.)