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At least 289 records · Page 16Linked to original sources
PubMed1991

Stapes surgery in osteogenesis imperfecta: analysis of postoperative hearing loss.

The disappointing results in 12 of 58 stapedectomies, including 4 revision operations, performed on osteogenesis imperfecta patients were analyzed and compared with reports in the literature. It is concluded that the results described as disappointing were not always the product of the stapes operation. A progressive sensorineural hearing loss arising independently of the operation as a result of progression in the disease process of osteogenesis imperfecta appears to have a severe influence on the final hearing threshold.

Adolescent↗
PubMed1997

Revision stapes surgery.

This paper reports on the analysis of 332 otosclerosis revision operations. The results have been evaluated with reference to the type of the procedure at primary surgery, the alleged cause of failure and the applied technical solution. The need for revision surgery was found higher after primary total stapedectomy (3.4 per cent) than after partial stapedectomy (2.2 per cent) or stapedectomy (two per cent). The reason for revision varied according to the originally applied technique eg a migrated piston, a too short piston and a lateralized graft are almost exclusively found after total stapedectomies. The median hearing gain after revision of stapedectomy and partial stapedectomy was higher (20 dB and 18 dB respectively) than that after revision surgery for total stapedectomy (12 dB), but significantly lower than hearing gain after primary surgery (32 dB). Revisions yielded better results in the case of primary interventions with the use of a piston or pistonwire than in the case of primary interventions with a wire-type prosthesis. The risk for sensorineural loss (one per cent) was not higher than in primary surgery.

Adolescent↗
PubMed2001

Efficacy of evaluation of audiometric results after stapes surgery in otosclerosis. I. The effects of using different audiologic parameters and criteria on success rates.

The Committee on Hearing and Equilibrium of the American Academy of Otolaryngology-Head and Neck Surgery proposed guidelines to provide more uniformity in reporting hearing results after middle ear surgery. One of the proposals was to include the hearing thresholds at 0.5, 1, 2, and 3 kHz in a 4-frequency pure-tone average (PTA) and to use post-operative bone-conduction (BC) levels rather than preoperative BC levels in describing postoperative air-bone gaps (ABGs). The hearing results of 451 stapes operations were evaluated to analyze to what extent the choice of different audiologic criteria affects success rates. It appeared that choice of PTA significantly affects postoperative gain in air-conduction thresholds and ABG levels. If one takes the improvements in speech-reception thresholds as the gold standard, the gain in air-conduction correlates best with a gain in speech-reception threshold if a higher frequency, such as 3 or 4 kHz, is included in a 4-frequency PTA. Also, choice of preoperative or postoperative BC in computing postoperative ABGs had a significant effect on the mean postoperative ABG levels, showing more favorable results with the use of preoperative BC thresholds.

Adolescent↗
PubMed1995

Value of computed tomography in patients with persistent vertigo after stapes surgery.

RATIONALE AND OBJECTIVES: The value of computed tomography was evaluated in 14 patients with persistent vertigo after otosclerosis operation. METHODS: High-resolution computed tomography was performed with 1-mm slice thickness and table feed in the axial and coronal planes. RESULTS: Computed tomography scans showed in 13 case findings that related to symptoms. An air bubble at the end of the prosthesis as a new, indirect sign of a perilymphatic fistula was found in 6 cases. An incorrect position of the stapes prostheses was diagnosed in 7 patients. One patient had recurrence of otosclerosis, and two others developed scarring around the prosthesis. In 1 case, an incus necrosis was found. Some patients showed two signs simultaneously. The computed tomography results were confirmed by retympanotomy in 12 cases. CONCLUSIONS: Computed tomography proved to be a valuable method in the diagnosis of persistent vertigo after otosclerosis operation. The indication for a repeat operation was facilitated by the use of computed tomography.

Follow-Up Studies↗
PubMed1995

[Diagnosis in persistent vertigo after stapes surgery].

One hundred sixty-two otosclerotic patients who underwent a stapedotomy between October 1991 and April 1994 were examined after experiencing postoperative vertigo. Twenty-eight complained of dizziness. In sixteen patients, we observed vertigo and nystagmus only within the first six postoperative days; in these cases, special treatment was not necessary. However, in twelve patients in whom vertigo persisted even after their stay in the hospital, the problem seriously affected their quality of life and their return to work. In these cases, an individualized diagnostic and therapeutic procedure was indicated. Case reports demonstrate the usefulness of several diagnostic methods (analysis of the case history, audiogram, investigation of the vestibular system, and elimination of non-vestibular causes of vertigo. But only high-resolution computed tomography scans of the temporal bone showed definite results. Air bubbles at the end of the prosthesis as indirect sign of perilymphatic fistula, bad position of the piston, new centers of otosclerosis, cicatrices, and in one case fracture of the prosthesis. Ten of the twelve patients required revision surgery. In most patients with persisting vertigo following stapedotomy, revision surgery was justified. However, high-resolution computed tomography is recommended.

Adult↗
PubMed1988

Revision stapes surgery.

The records of 120 patients who had undergone revision stapedectomy were analyzed to determine: (i) the causes of failure; (ii) how to prevent failure by taking precautions during primary surgery; (iii) hearing results; and (iv) possible identifying factors which might pinpoint those patients with a high risk of sensorineural deafness. A review of these cases demonstrates that the results of revision stapedectomy are different from those of primary stapedectomy. The commonest cause of failure was prosthetic dislocation (30.8 per cent), followed by fibrous adhesions (18.3 per cent) and otosclerotic regrowth (14.1 per cent). First revision operations resulted in post-operative bone-air gaps of 15 dB. or less in 46.5 per cent of cases, much better than 25 per cent for second revisions. Primary stapedectomy resulted in successful closure of the air-bone gap to 15 dB. or less in 89.5 per cent of cases. The sensorineural loss occurred in 11.3 per cent or first revisions and in 16.6 per cent of second revisions, as compared to 1.3 per cent after primary surgery. 'Dead ears' were encountered in 2.2 per cent of first revisions, as compared to nil in the primary group.

Adolescent↗
PubMed1976

[Nomenclature of tympanoplastic and stapes surgery (author's transl)].

Suggestions are made regarding the nomenclature of middle ear surgery which is partially based on previous terminology. By means of this nomenclature, reconstructive procedures can be defined shortly and precisely by a single term both from an anatomical and a functional point of view thus facilitating a statistical analysis.

Humans↗
PubMed1983

[Functional results of stapes surgery].

In 135 patients the functional results of stapedotomy and stapedectomy were controlled. As a rule, stapedotomy results were superior to stapedectomy results. Small hole stapedotomy using a 0.4 mm. teflon-wire piston yielded optimal sound transmission between 500-8000 Hz. In addition, this was the only technique to prevent cochlear damage at 4000 Hz and 8000 Hz.

Adult↗