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Results for “Stapes Mobilization”

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At least 235 records · Page 13Linked to original sources
PubMed2006

Predictive role of Carhart's notch in pre-operative assessment for middle-ear surgery.

OBJECTIVES: To evaluate the predictive role of the audiometric Carhart's notch for the assessment of middle-ear pathology prior to surgical intervention. METHOD: In this retrospective analysis, a total of 315 operated ears of 305 patients were evaluated regarding their pre-operative pure tone audiograms and peri-operative findings. The probable relationship between the middle-ear pathologies found and the Carhart's notch found on pre-operative pure tone audiometry was investigated. Patients with conductive hearing loss who obtained at least a 10 dB improvement (at 1 and 2 kHz frequencies) in their bone conduction threshold post-operatively were included in the Carhart's notch group. The pathologies underlying Carhart's notch were compared. RESULTS: Three hundred and fifteen ears of 305 consecutive patients with conductive hearing loss were operated on due to middle-ear pathology. In patients with otosclerosis and tympanosclerosis, a Carhart's notch was seen at 2 kHz in 28 (93 per cent) patients but at 1 kHz in only two (7 per cent). However, in patients with chronic otitis media, a Carhart's notch was seen at 1 kHz in 10 (55 per cent) patients and at 2 kHz in eight (45 per cent) patients. CONCLUSIONS: Otitis media with effusion, tympanosclerosis and congenital malformations should be considered in the differential diagnosis of a patient with a Carhart's notch seen on pure tone audiometry. A Carhart's notch at 2 kHz indicates stapes footplate fixation, whereas one at 1 kHz indicates a mobile stapes footplate; the footplate mobility can thus be predicted pre-operatively.

Adolescent↗
PubMed2002

Congenital conductive hearing loss.

Congenital conductive hearing loss due to ossicular deformities can be treated by either rehabilitation with a hearing aid or surgical reconstruction. We present the results of exploratory tympanotomy performed in a large paediatric otolaryngology centre in 67 patients with non-serous congenital conductive hearing loss. Forty-two children had malformation of one or more ossicles without fixation of the stapes, and 19 had fixed stapes. In 26 cases, the surgeon decided not to perform surgical correction. Seven operated patients were lost to follow-up. As a group, 47 per cent of the patients who underwent reconstruction showed no significant benefit from surgery, with post-operative air-bone gaps (ABG) greater than 30 dB. Assessment of the results by pathology showed that 64 per cent of the patients with mobile stapes had an air-bone gap within 30 dB compared to only 33 per cent of the patients with fixed stapes. One patient sustained severe sensorineural loss after the procedure. Considering that exploratory tympanotomy is a relatively minimal, benign procedure but that findings during exploration may exclude the option of reconstruction (in 39 per cent of our patients), we suggest exploring the ear, but in a more realistic, informed way.

Adolescent↗
PubMed1959

Tympanotomy: exploratory "laparotomy" of the middle ear.

In some cases of conduction deafness or mixed deafness, direct inspection of the area believed to be involved is the only means by which diagnosis can be made with certainty. This can be done by a method of tympanotomy that is used for stapes mobilization. The necessary exposure is done with local anesthesia, is not painful, is well tolerated by the patient and requires only two days in hospital. Reparative procedures may be carried out as indicated.

Anesthesia, Local↗
PubMed1975

[Deafness and Paget's disease].

Cases of deafness due to Paget's disease can be separated into two types : (1) deafness of a mainly mixed type in which progressive aggravation occurs particularly in the inner ear, and (2) perceptional deafness which progresses without involvement of the transmission apparatus. Among 35 hospitalized patients with Paget's disease, 21 of whom suffered cranial involvement, 18 cases of deafness related to the bone disease were discovered by means of systematic examinations. The deafness was of the mixed type in 11 cases and of the perceptional type in the other 7. Of the 11 patients with the mixed type of deafness with an ankylosis syndrome of the ossicles, 3 were operated upon : one of them underwent an operation to mobilize the stapes, and the two others underwent total stapedectomy followed by venous interposition and the positioning of a Teflon piston. The long-term results were frankly disappointing and did not suggest that these attempts at surgical treatment should be followed up. Calcitonin was employed in 9 patients (6 with mixed deafness and 3 with perception type deafness), with comparative audiograms in 5 cases, and was also not very effective : this lack of effect was a result of the long duration of the Paget's disease and of the deafness in the patients treated. The value of hormonal treatment in cases of deafness associated with Paget's disease will probably be in the prevention of this complication.

Aged↗
PubMed2006

Rosen mobilization of the stapes: does it have a place in modern otology?

We describe two patients with stapes fixation, in both of whom Rosen mobilization seemed to be the most prudent surgical choice. In both cases, a useful hearing gain was achieved initially. In the patient with otosclerosis, the conductive hearing loss recurred and a stapedectomy was subsequently carried out. In the patient with congenital stapes fixation, the hearing gain was maintained for two years eight months. We believe that this technique still has a place in stapes surgery in rare instances.

Adolescent↗