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At least 235 records · Page 13Linked to original sources
PubMed1987

Far-advanced otosclerosis. Cochlear implantation vs stapedectomy.

In 1981, our group, as part of a Food and Drug Administration investigator team directed by William House, performed Illinois' first cochlear implantation. We have since performed cochlear implantations in ten other persons. Since May 1980, approximately 35 severely to profoundly deaf persons per year have been referred to our clinic for evaluation. A small number of these patients had far-advanced otosclerosis. In these cases, exploratory tympanotomy and stapedectomy followed by rehabilitation with a hearing aid was a more appropriate management than cochlear implantation. Case histories and a temporal bone study of far-advanced otosclerosis are presented.

Aged↗
PubMed1988

Surgically confirmed clinical otosclerosis among the Chinese.

We report herein on 163 cases of surgically confirmed otosclerosis among Chinese. Our results suggest significant racial differences between Chinese and whites in respect to the incidence of this disease, and the likelihood of a family history. Surgical and histopathological findings, while confirming otosclerosis identical to that experienced in whites, suggest that generally the disease is milder among Chinese. The sex ratio, age range, and bilateral involvement, on the other hand, were discovered to be basically similar between the two races. A detailed description is given of the postauricular surgical technique used, and it is argued that it may be more suitable in cases where there is a small ear canal, since the results achieved (80% success rate) are comparable with other reports.

Adolescent↗
PubMed1979

Progressive sensorineural hearing loss and cochlear otosclerosis: a prospective study.

The association of otosclerosis with reduced bone conduction is well known but no experimental or valid clinical relationship has been established to confirm this relationship. The purpose of this presentation is to demonstrate a clinical relationship between otosclerosis and sensorineural hearing loss. Experimental proof will await the accumulation and study of temporal bones of those individuals who, in life, exhibited the clinical relationship to be developed in this dissertation.

Adolescent↗
PubMed2001

Surgery of otosclerosis in the elderly.

Auditory results following stapes surgery in 26 patients with otosclerosis >60 years of age at the time of surgery were compared with those obtained in 140 patients <60 years undergoing stapes surgery during the same time period. Stapedotomy was performed in all cases. The mean follow-up period was 29 months. Hearing results as judged by postoperative air-bone gaps were as good in the older age group as in the younger patients. Moreover, complications of surgery, such as postoperative formation of perilymphatic fistula, did not occur more frequently in elderly vs younger patients. On the basis of the results obtained, it is concluded that stapes surgery should be offered to elderly patients with the same indications as younger patients with otosclerosis.

Adult↗
PubMedDate not supplied

Bone conduction thresholds in patients with otosclerosis.

PURPOSE: Sensorineural hearing loss in patients with otosclerosis is commonly encountered. This study was conducted to determine if surgery on the otosclerotic ear had an effect on the sensorineural hearing. METHODS: A cohort of 262 patients subjected to operation in 311 ears were evaluated. All patients had a minimum of 5 years follow-up and patients over 60 years of age were excluded. Audiograms obtained 1 day before surgery were compared with those obtained 1 year postoperatively and at the last follow-up examination in the study. Results were evaluated using the Student's t test for statistical analysis of hearing results. RESULTS: The mean follow-up was 9.6 years. Deterioration of bone conduction scores occurred in 6.4% of 311 operated ears. Deterioration of bone conduction threshold occurred in the speech frequency in 6 ears (1.9%). CONCLUSIONS: Bone conduction scores of operated ears remained quite stable compared with the otosclerotic ears not subjected to operation. Patients with bilateral otosclerosis may benefit from surgery performed on both ears when indicated.

Adult↗
PubMed2005

Argon laser assisted small fenestra stapedotomy for otosclerosis.

To report and analyse our results and complications of argon laser assisted stapedotomy for primary otosclerosis. A retrospective analysis of 135 consecutive cases of primary otosclerosis operated by the senior author (JH) has been performed. The air-bone gap was calculated by using the pure tone average at 500, 1000, 2000 and 4000 Hz. A separate analysis of air-bone gap at 500, 1000 and 2000 Hz was carried out to assess the effects of a small diameter piston on low frequency hearing. Hearing at high frequencies (4000 and 8000 Hz) was also assessed to evaluate effects of small fenestra technique on high frequency hearing. Preservation of cochlear function was assessed by comparing the average pre- and post-operative bone conduction thresholds. Complications arising were analysed. The post-operative air-bone gap at 0.5, 1 and 2 kHz was 10 dB or less in 85.19% of patients and 20 dB or less in 97.04% patients. The air-bone gap at 0.5-4 kHz was <or=10 dB in 77.04% of patients and 20 dB or less in 97.04% patients. The majority of patients showed an improvement at 4 kHz (81.4%) and 8 kHz (60.7%). There was no change in the average pre- and post-operative bone conduction thresholds. There were no major complications. Argon laser reduces mechanical trauma to the vestibule and increases precision resulting in consistent hearing results in all frequencies and reduced post-operative morbidity.

Adult↗
PubMed2003

[Possible benefits of calcitonin in the treatment of otosclerosis].

This study shows the results obtained after treatment with intranasal calcitonin in 23 patients (36 ears) suffering from otosclerosis. 19.4% showed a hearing improvement upper of 10 dB. The gain was 32 dB in air conduction thresholds and 23 dB. In bone conduction. Tinnitus disappeared in 25% of cases suffering from tinnitus. Calcitonin tolerance was good, 8.7% of patients reported migraine. Authors recommended additional studies in order to evaluate the efficacy of this drug in the treatment of otosclerosis.

Adolescent↗
PubMedDate not supplied

Pathology of otosclerosis: a review.

Otosclerosis is a bone disorder of unknown etiology confined to the otic capsule. Failure of remodeling of newly formed vascular, woven bone (otospongiosis) results in sclerotic bone (otosclerosis) with abnormal osteons. Involvement of the oval window causes conductive hearing loss. Electron microscopic, histochemical, and biochemical studies identify normal cellular and matrix components of otosclerotic bone without providing clues to the abnormal bone formation and resorption. Plastic-embedded, nondecalcified histologic sections with in vivo tetracycline labels permit the study of mineralization rates to separate this disorder from other bone dyscrasias that have similar histopathologic appearances. Characterization of the cells, matrix, and their mediators can yield an understanding of abnormalities that disorder bone.

Animals↗
PubMedDate not supplied

Otosclerosis and sensorineural hearing loss: a histopathologic study.

The precise role and mechanism whereby otosclerosis is associated with sensorineural hearing loss remains unclear. Previous histopathologic reports are inconsistent with regard to the location of the otosclerotic focus, invasion of the otic capsule, and the number of remaining peripheral sensorineural elements. From the combined temporal bone collections of the University of Chicago and the Mayo Clinic, we identified a group of 125 ears from 80 patients, all with confirmed otosclerosis. Six of these ears were associated clinically with sensorineural hearing loss without stapes fixation. The histopathology of the otosclerotic focus was reviewed in terms of its location and depth of invasion. The cochlea and spiral ganglion were reconstructed, and the state of the organ of Corti and the presence or absence of peripheral cochlear nerve fibers were noted. Correlations with ganglion cell counts were made. The present study showed that the pattern of degeneration of peripheral sensory and neural elements in the cases presented is very similar to that found in cases of age-related processes such as presbycusis.

Aged↗
PubMedDate not supplied

Otosclerosis: a local manifestation of a generalized connective tissue disorder?

The hypothesis that otosclerosis is a local manifestation of a clinically and genetically heterogeneous group of generalized connective tissue disorders was tested by quantitative biochemical techniques. In contrast to previous studies, no significant differences were found in individual glycosaminoglycans excreted in urine of control subjects and patients with otosclerosis. Moreover, no significant differences were detected in the rate of synthesis and secretion of glycosaminoglycans and collagen in skin fibroblast cultures of patients and controls. Preliminary results obtained with more sensitive and specific methods suggest a possible error in collagen metabolism. Polyacrylamide gel electrophoresis revealed slight differences in migration patterns of several collagenous proteins between patients and control subjects. In addition, collagenase was significantly increased in three of five patients.

Cells, Cultured↗
PubMedDate not supplied

Fine morphology of bony dysplasia of the murine ear: comparisons with otosclerosis.

Dysplastic bony lesions that bear certain similarities to otosclerosis occur spontaneously in LP/J inbred mice. These lesions develop after the fifth week of life and progressively enlarge; they are present in 90% of animals by 90 weeks of age. In the present study, the fine morphology of these lesions was investigated. Dysplastic lesions in the middle ear of LP/J mice appeared to begin as subperiosteal accumulations of amorphous material. These accumulations occurred adjacent to the bone surface below the epithelium of the middle ear. This amorphous material was often associated with macrophages on the adjacent epithelial surface. The material appeared to be replaced with collagen fibers in a disorganized manner, forming a homogeneous base (osteoid) on which calcification occurred. The fine morphology and periodicity of the collagen appeared normal. The lesions then calcified by forming calcospherites that became confluent. During this period, transformed fibroblasts (osteoblasts) appeared in the calcifying matrix, resulting in a lesion made of bone. These lesions could sometimes be seen replacing normal bony contours but most often were exophytic. The lesions at all stages of development may be associated with macrophages and effusions in the middle ear. The lesions in the middle ear of LP/J mice appeared to develop by an active process of bone formation; in contrast, otosclerosis is an active process of bone resorption and formation.

Animals↗
PubMedDate not supplied

Success in surgery for otosclerosis: hearing improvement and other indicators.

PURPOSE: This retrospective study investigates the general outcome and subjective impression of patients who have undergone surgery for otosclerosis. Postoperative complaints and complications, as well as hearing results, are also reported. MATERIALS AND METHODS: Questionnaire and audiomeric results of 246 stapes surgery patients (270 operations) were studied. RESULTS: Hearing results showed a mean improvement in pure-tone average of 26 dB and air-bone gap closure to within 10 dB in 214 cases (79%). No serious complications or profound sensorineural hearing loss occurred. Patients were generally pleased with surgery, and subjective evaluation of benefit corresponded with objective audiometric result. However, a variety of complaints, such as vertigo, tinnitus, loud noise intolerance, pain, chorda tympani symptoms, and sound distortion problems, were reported. Most of these symptoms correlated significantly with the patients' subjective opinion of the surgical outcome. CONCLUSION: Patients as well as surgeons consider hearing improvement as the main indicator of success in surgery for otosclerosis. However, postoperative symptoms and complaints can be expected in a certain percentage of patients. Because these can influence the general outcome of surgery, the ear surgeon should try to painstakingly refine his technique in an effort to minimize their sources. They should also be discussed in preoperative patient counseling.

Adult↗
PubMed2005

[Imaging of postoperative failures and complications in stapes surgery for otosclerosis].

Otosclerosis (OS) is a dysplasia of the otic capsule located in most cases on the anterior margin of the oval window or fissula ante fenestrum. Progressive conductive hearing loss is the major clinical symptom, due to stapedovestibular ankylosis. Stapes surgery is the only effective treatment of OS, with excellent functional results in more than 90% of cases. However, failures and complications of the surgery may be observed. In theses cases, the etiologic work-up includes imaging evaluation (CT and MRI). Imaging findings are extremely useful in the therapeutic decision. Surgical failure represents 80% of the causes for surgical revision. The main causes of failure are: displacement of the prosthesis, fibrosis of the oval window, erosion of the long process of the incus, incudo-mallear dislocation, obliterative otosclerosis. CT is essential for diagnosis. MR imaging is rarely indicated in the work-up of surgical failures. Labyrinthine complications account for less than 20% of surgical revisions. Etiologies of labyrinthine complications are: intravestibular penetration of the prosthesis, perilymphatic fistula, intra-vestibular granuloma, labyrinthitis and intravestibular bleeding. CT and MRI are complementary for the work up of these complications.

Adult↗
PubMed2006

[Otosclerosis imaging: matching clinical and imaging data].

Otosclerosis is a primitive osteodystrophia of the labyrinthine bone. Its diagnosis must be confirmed by a CT scan in order to eliminate the other causes that may lead to conductive hearing loss with an absence of stapedial reflex: fixation of the head of the malleus to the lateral wall of the tympanic cavity, absence of the long process of the incus or stapes, gusher syndrome, primary cholesteatoma, or tympanic facial nerve neuroma blocking the stapes. Particular problems in otosclerosis must be clarified: an extension to the round window (poor postoperative results), and extension to the tympanic cavity blocking the malleus and/or the incus, the labyrinthine lumen, or the internal auditory meatus (very rare). The position of the tympanic facial nerve canal and associated abnormalities must be assessed: stapedial artery, malformations of the ossicles and/or the labyrinth, and chronic otitis media. MRI is indicated in extension to the labyrinthine lumen, the internal auditory meatus, and in postoperative complications with labyrinthitis. MRI can also evaluate the active otosclerotic focus (gadolinium enhancement).

Adult↗
PubMed2002

Reparative granuloma seen in cases of gold piston implantation after stapes surgery for otosclerosis.

OBJECTIVE: to determine the occurrence of the unusual side effect of a reparative granuloma after the implantation of a pure gold piston in cases of otosclerosis. STUDY DESIGN: a retrospective case review study of 475 stapes operations with a pure gold piston. SETTING: Department of Otorhinolaryngology of the University of Amsterdam, The Netherlands and the HNO clinic in Luenen (Brambauer) in Germany. PATIENTS: four hundred and seventy five patients (328 women, 147 men, average age: 45.2 years), who clinically and per-operatively had otosclerosis, underwent a stapedotomy using a pure gold piston prosthesis. Therapeutic intervention: in cases of suspicion of a reparative granulomas or those cases that did not have improvement of the hearing after the stapedotomy, a re-operation by transcanal approach was performed. RESULTS: in seven cases a reparative granuloma was diagnosed by this revision surgery. The postoperative incidence of these granulomas following stapedotomy using the pure gold piston turned out to be 1.5%. CONCLUSION: reparative granulomas can occur after stapedotomy with a pure gold stapes piston although the incidence is low. The role of grafting material to seal the oval window niche and the treatment of these reparative granulomas following stapes surgery are discussed.

Ear Diseases↗
PubMed1998

Experience with a new pure gold piston in stapedotomy for cases of otosclerosis.

This study reports the evaluation of the hearing results after 62 implantations of a pure gold (99.9%) piston in cases of otosclerosis. A retrospective analysis of the pre- and postsurgery audiological results of these patients was carried out by microcomputer. This study shows that the use of a pure gold piston ((K-piston) with a diameter of 0.4 mm gives good results in cases of stapedotomy for otosclerosis. The hearing results show a closure of the pure-tone average (PTA) air-bone gap to within 10 dB was 70.9% (44/62) and to within 20 dB in 95.1% (59/62). A residual airbone-gap of > 20 dB was seen in three cases (4.8%). A postoperative overclosure of bone conduction thresholds was discovered for all frequencies measured. Sensorineural hearing loss (> 10%) did not occur and there was no decline in the speech discrimination. The future for this new generation of stapes pistons seems to be promising.

Adult↗
PubMed1983

HLA-A, -B, -C antigens in otosclerosis.

One hundred unrelated, randomly chosen, consecutive patients with otosclerosis, verified by operation, were typed for HLA-A, -B, -C antigens. No significant association between HLA-A, -B, -C antigens and otosclerosis was found.

Adult↗
PubMed1998

Stapedectomy for far-advanced otosclerosis.

Patients with far-advanced otosclerosis (FAO) may appear to be suffering from profound sensorineural hearing loss and are frequently directed to cochlear implantation programmes. In order to avoid such misdiagnosis, FAO should be considered in patients with non-measurable bone-conduction levels and air-conduction levels exceeding 85 dB. Specific clues can lead the clinician to suspect otosclerosis as the aetiology of hearing loss. A review of eight patients (nine ears) with FAO who underwent stapedectomy from 1985-1995 reveals that six of the eight (75 per cent) who had been unable to use a hearing aid preoperatively obtained serviceable hearing with a hearing aid after surgery. This confirms that cochlear implantation is not the best treatment for all profoundly deaf patients; some are better off with stapedectomy.

Aged↗