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At least 271 records · Page 15Linked to original sources
PubMed1995

[Stapes revisions: clinical findings and results].

By correlating the intraoperative findings and the postoperative hearing gain it was attempted to determine the recommendable intraoperative management in stapesrevisions in order to obtain the best postoperative hearing. In a retrospective study the findings of 39 stapes revision operations were analyzed. In most of the cases hearing one year postoperatively was compared with preoperative hearing. The prognosis for good hearing was best following replacement of the prosthesis where the prosthesis was too short or dislocated, or in the presence of a loosened wire. Where treatment only entailed retightening the loosened wire at the long process of the incus, postoperative hearing did not improve. Patients with an obliterative otosclerosis or an additional fixed incus had a less favorable prognosis. Overall a postoperative air bone gap of 10 dB or below was obtained in 44% of the patients and a postoperative air bone gap of 20 dB or below in 77% of the patients. Twenty-one percent of the patients remained unchanged, and in one patient postoperative deterioration of the hearing was detected.

Adult↗
PubMed2001

Long-term stapedectomy results with the McGee stapes prosthesis.

OBJECTIVE: To report long-term follow up on patients undergoing stapedectomy with the McGee stapes prosthesis. STUDY DESIGN: A retrospective case series. METHODS: Charts recording 170 stapedectomies (120 primary and 50 revision stapedectomies) from 1989 to 1999 were analyzed, and audiometric data and the findings at repeat exploration reported. RESULTS: Over a 10-year period, 11.2% of patients had failure of their initial air-bone gap closure with the McGee piston. Seventy-seven percent (in 10 of 13 patients) of McGee pistons that failed were found to have the platinum ribbon displaced laterally from the incus and the piston pushed out of the stapedotomy. The failure rate was not significantly different (P =.72) from that in our patients who underwent placement of a Robinson cup prosthesis (9.5%), but the pattern of displacement was unique. Failures occurred earlier with the McGee piston (average time to failure of 2.5 y) than with the Robinson cup (average time to failure of 8.6 y). CONCLUSION: The McGee piston was found to have a unique pattern of dislocation that is likely related to the malleable nature of the platinum ribbon and loosening of the crimped "shepherd's crook" over time.

Follow-Up Studies↗
PubMed2005

Congenital stapes footplate fixation associated with duplication of lobule.

We report the case of an 18-year-old male patient who presented to us with unilateral conductive hearing loss with duplication of the lobule. An exploratory tympanotomy revealed stapes footplate fixation. A stapedotomy with insertion of a Teflon piston was performed with improvement in his hearing. We believe this is the first reported case of such an abnormality.

Abnormalities, Multiple↗
PubMed1976

Recurrent meningitis and labyrinthine gusher, related to congenital defects of the labyrinthine capsule and stapes footplate.

A congenital defect in the bony footplate of the stapes is now known to be a point of lowered resistance to extension of bacterial middle ear suppuration to the vestibule and thence to the meninges. Tomographic demonstration of the congenital pathologic condition of the ear permits the surgeon preoperatively to chart his surgical course. Despite antibiotic and chemotherapy, recurrent meningitis remains a serious disease as manifested by the death of two of the patients reported. The capacity for surgical correction of the congenital defect is manifested by one of our patients who has been free of meningitis for more than two years after surgery. If a congenital defect is considered in each case of recurrent meningitis, it is believed the mortality of this serious disease can be reversed.

Adult↗
PubMed1976

The knotted wire in stapes surgery: one possible factor in postoperative sensori-neural hearing loss.

In four instances of revision stapedectomy in patients with sensori-neural hearing loss, with or without dizziness, a wire prosthesis was found with an extention beyond the knot which could impinge on the contents of the vestibule. Four commercially manufactured knotted wire prostheses were examined, and the end of three was found projecting beyond the knot. The wire piercing the membranous labyrinth appears to be one of the factors in causing further sensori-neural hearing loss after stapedectomy. A wire loop or piston prosthesis should be considered to eliminate the hazard of a trailing end of a knotted wire in stapes surgery.

Adult↗
PubMed1990

An autosomal dominant inherited syndrome with congenital stapes ankylosis.

A newly recognized autosomal dominant inherited syndrome associated with congenital conductive deafness, hyperopia, broad thumbs, broad first toes, short distal phalanges, and syndactyly is reported. The conductive loss was the result of congenital stapes ankylosis and, in two cases, was associated with ankylosis of the short process of the incus in the fossa incudis. Stapedectomy improved hearing in these patients. Fused cervical vertebrate are also an associated feature.

Adult↗
PubMed1992

[Ossicular reconstruction of the loss of the superstructure of the stapes].

At 43 patients the full or almost full reconstruction of the sound conductive system of the middle ear has been performed. The colemella from autogenous cartilage was positioned on the footplate of the stapes or the mallens was rotated on the footplate. In the 4 years after operation the negative functional results were found. The applied operations techniques have been criticised.

Adolescent↗
PubMed1987

[Rupture of the membrane of the round window in stapes fixation].

A case of sudden deafness is described. Examination showed a mixed deafness on the left side, suspected to be due to fixation of the stapes and a simultaneous perilymph fistula. These lesions were proved by an exploratory tympanotomy. The interesting aspects of the case are emphasized: firstly recruitment caused by a perilymph fistula, present for 5 months without causing complete deafness; secondly improvement of hearing after surgical treatment of both pathological conditions; and finally the complete absence of vestibular signs.

Adult↗
PubMed1979

An unusual case of stapes fixation.

A case of fixed columella stapes is described by a patient of 39 years with bilateral conductive hearing loss, a mitral valve pathology, bat ears, clinodactyly and hallux valgus. This complex of anomalies can be considered a hazardous association or an incomplete form of the Forney-Robinson-Pascoe syndrome. Stapedectomy with interposition of a vein graft and a teflon piston gave a total closure of the air-bone gap.

Abnormalities, Multiple↗
PubMed1983

[Surgery of the footplate of the stapes excluding otospongiosis: critical study of a series of 60 cases].

Operations on the foot of the stapes, excluding for otosclerosis, were performed in 60 patients: 5 mobilizations and 55 excisions. Surgery was for aplasia in 7 cases, injury in 5 cases, tympanosclerosis with a closed membrane in 17 cases (mobilization was performed in 5 of these patients), elective excision with a healthy cavity in 16 cases, and 15 involuntary excisions including 10 with an open membrane. Stapedectomy is a serious operation when the ear is open, whether it is performed for simple chronic otitis, or cholesteatomatous or tympanosclerotic otitis, risks being independent of age. The use of an appropriate technique can provide substantial functional gain in aplasias and tympanosclerosis with a closed membrane.

Adolescent↗
PubMed1981

[Ankylosis of the stapes by post-inflammatory osteogenesis (or syndrome of Coyle Shea Jr). Report of two cases (author's transl)].

Ankylosis of the stapes by post-inflammatory osteogenesis (syndrome of Coyle Shea Jr) is a pathologic entity still not well known, often confounded with otosclerosis. If surgical treatment is the same as for otosclerosis (stopedectomy, platinectomy, veinous graft and piston), the prognosis is not the same and a great carefulness is necessary, as well in operatory indications as in operatory procedure itself.

Adult↗
PubMed1976

[Presentation and treatment of stapes dislocation and subluxation (author's transl)].

The symptomatology, especially vestibular, and the surgical findings in traumatic dislocation of the stapes into the oval window are described in 2 patients, one of whom seen 1 3/4 h after the accident and the other after 12 days. The main indication for exploratory tympanotomy was change of the spontaneous nystagmus from an irritative to a paretic type. Special attention should be given to positional nystagmus, which increases on turning onto the affected side, the mechanism for which is apparently similar to the positional vertigo of labyrinthine fistulae. Hearing was preserved in both patients. In one patient, vestibular function recovered considerably whilst in the other, there remained considerable impaired function.

Accidents, Home↗
PubMed2000

Tonotopic cortical changes following stapes substitution in otosclerotic patients: a magnetoencephalographic study.

The aim of the study was to investigate and follow up the tonotopic organization of the primary auditory cortex in otosclerotic patients before and after corrective surgery. The characteristics of primary auditory cortex activation were studied in ten otosclerotic patients (i.e., subjects suffering from a conductive hearing loss, prior to and following stapes substitution). Magnetoencephalographic recordings of auditory evoked fields by tone-burst stimulation at octave frequencies between 250 and 2000 Hz were performed during monaural stimulation. The brain topography of the main cortical response (N100m) generators at different tones was studied in patients and compared with ten healthy controls; pre- post-surgical changes were also correlated to their clinical outcome following corrective surgery. A significant decrease of the tonotopic extension in the cortical region responsive to the four explored frequencies was found in patients before surgery with respect to the control population. At the time of postsurgical follow-up, the tonotopic representation had enlarged and was approaching the dimensions seen in normal subjects, although with higher variability. The extent of the enlargement of the postoperative tonotopically organized area was directly correlated with the postsurgery period duration. Our findings indicate that auditory cortical areas of human adults undergo functional reorganization following peripheral alteration of the sensory input entering the CNS. The restriction of the cortical tonotopic region caused by the long-term reduction of acoustic input is followed by a reorganization within the usual boundaries following the recovery of auditory function; this process is taking place in a time scale of a few weeks.

Adult↗
PubMed1988

The gene for X-linked progressive mixed deafness with perilymphatic gusher during stapes surgery (DFN3) is linked to PGK.

A linkage analysis has been performed in a large Dutch kindred with progressive mixed deafness with perilymphatic gusher during stapes surgery (DFN3) using a panel of X-chromosomal RFLPs. Tight linkage (zmax = 3.07 at 0 = theta = 0.00) was demonstrated with the locus for phosphoglycerate kinase (PGK), which is located at Xq13. Tight linkage was excluded for DXS9 (probe RC8) and DXS41 (probe 99.6) on Xp and for blood clotting factor 9 (FIX) on distal Xq. Deafness is one of the predominant clinical features in males with deletions of the Xq21 band. Our results suggest that this association may be due to involvement of the DFN3 gene.

DNA Probes↗
PubMed1984

Operative treatment for otosclerosis. Comparative study of long-term results following substitution of stapes by free cartilage grafts.

This comparative study of long-term results following the substitution of stapes by free cartilage grafts is based on 500 stapedectomies. The patients were operated on by the same surgeon (first author) and followed-up for a period of 5-20 years. Postoperative results, compared with the results of other stapedectomy techniques, demonstrate a statistically significant difference in favour of the cartilage implant technique with respect to the overall functional success rate and the incidence of postoperative complications.

Adolescent↗
PubMed1995

The effect of preoperative bone conduction threshold levels on the results of stapes surgery.

The effect of preoperative bone conduction (BC) threshold levels on the results of stapedectomy was evaluated in 378 adult patients with otosclerosis. The mean follow-up period was 8.8 years. Both short-term and long-term postoperative hearing levels were found to be significantly dependent on preoperative BC levels. Only 2 of 31 patients (7%) with preoperative BC thresholds > 40 dB had postoperative hearing levels of 30 dB or better. However, hearing still improved by > or = 21 dB as often in patients with elevated preoperative BC thresholds as in patients with normal BC thresholds. These findings support the use of stapes surgery being worthwhile even in patients with highly elevated BC thresholds.

Adult↗