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At least 325 records · Page 18Linked 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↗
PubMed1996

Facial canal dehiscence: a report of 1,465 stapes operations.

We retrospectively reviewed 1,465 stapes operations for facial canal dehiscences. The incidence of facial canal dehiscence was found to be 11.4%. A facial canal dehiscence with protrusion of the facial nerve is more common than a dehiscence without protrusion. In addition, 3 cases (0.2%) had a herniation of the facial nerve. Our data suggests that heredity could be one of the factors associated with a facial canal dehiscence. If an operated ear shows a dehiscent facial canal, there is a 29% possibility that the contralateral ear also has a dehiscence. Bilaterality of facial canal dehiscence is, therefore, exceptional.

Facial Nerve↗
PubMed1994

Revision stapes surgery: a critical evaluation.

Fifty-six revision stapes surgeries performed during the last 9 years were evaluated retrospectively for their preoperative symptoms, intraoperative findings, and postoperative results according to the causes of failure, at the Gruppo Otologico, Piacenza, Italy. The most frequent causes of failure were found to be prosthetic misalignments, a reaction to the surgical trauma in the form of excess fibrous tissue reaction or new bony regrowth at the oval window, and ossicular chain problems. The location of the pathology was found to be an important factor in the outcome. Sixty percent of cases resulted in 0- to 20-dB air-bone gap. The causes of these failures, management, and their prevention during primary surgeries are also discussed.

Adult↗
PubMed1995

An automatic technique for micro-drilling a stapedotomy in the flexible stapes footplate.

This paper describes a technique for controlling the drill bit breakthrough during low-speed micro-drilling of a flexible bone element. The research reported focuses on the penetration of the stapes footplate at the boundary of the middle and inner ear where there is a need to minimize the penetration of the drill bit through the medial surface. The bone is of unknown thickness and compliance, and the efficiency of cutting is variable between specimens. An automated system is presented that is able to determine these unknowns, to detect the onset of breakthrough and to control drill protrusion beyond the medial surface. The methods used to determine and control the level of protrusion on breakthrough are described. It is reported that the drill bit protrusion beyond the medial surface is achieved to within 0.02 mm of the ideal position.

Evaluation Studies as Topic↗
PubMed1976

Stapes fixation in chronic middle ear disease.

Rigid stapes fixation is not uncommonly found in chronic otitis media and can be caused by several conditions. Careful stapedectomy with some form of ossicular chain reconstruction is the treatment of choice, usually as a second stage procedure. Hearing results to date have been gratifying.

Chronic Disease↗
PubMed1976

Human stapes crura: surface bone architecture: scanning electron microscopic findings.

Human stapes crura obtained at the time of stapedectomy for clinical otosclerosis have been studied after removal of the mucosal and periosteal layers by treatment with hydrogen peroxide and ultrasonification. With the scanning electron microscope, four basic architectural patterns are evident: honeycomb, fibrillar, compact and pitted. The significance of these patterns is as yet unclear, but they do appear to be in intimate relationship one to another and perhaps are varying stages in a single process.

Ear Ossicles↗
PubMed1980

An evaluation of revision stapes surgery.

The expected success rate in primary stapedectomy is well documented in recent literature, but few reports have commented on the difficulties or the expected results in revision stapes surgery. Reports have dealt with different techniques, but the surgeon and the patients should be aware of the problems and risks involved in revision stapedectomy. The records of 35 patients who had undergone revision stapedectomy were analyzed to determine the following: 1. cause of failure, 2. how to avoid these difficulties, 3. hearing results, and 4. possible identifying factors which might pinpoint those patients with a high risk for sensorineural hearing loss. A review of these cases demonstrates that the results of revision stapedectomy are different than those for primary stapedectomy.

Hearing Loss, Sensorineural↗
PubMed1993

Manipulating the mobile stapes during tympanoplasty: the risk of stapedial luxation.

Manipulating the mobile stapes is a central procedure during tympanoplasty, i.e., mounting a prosthesis onto the stapedial head or dissecting cholesteatoma matrix off the oval window niche. An excessive displacement of the stapedial suprastructure as caused by these manipulations with hand-held instruments might result in a rupture of the annular ligament. Bacteria invading through this perilymphatic fistula threaten the inner ear. In experiments with temporal bones, the author investigated the rupture mechanisms of the annular ligament with definite stapedial manipulations. Leaks, which became detectable by exerting pressure on the inner ear fluid, occur only when all suspension fibers are completely ruptured. Further clinical aspects with different directions of stapedial manipulations are demonstrated.

Cochlear Diseases↗
PubMed1994

Spanner malleus-stapes/footplate assembly.

A simply prepared and implanted ossiculoplasty prosthesis is described for use when the malleus is suited to assembly procedures. The one versatile hydroxylapatite and Teflon model is suitable for both the malleus-stapes and malleus-footplate role. Clinical trials of 80 prostheses in place for 5 to 18 months have confirmed excellent surgical handling properties combined with optimal audiological results.

Ear Ossicles↗
PubMed1994

Revision stapes surgery with and without laser: a comparison.

In this study, the results of 76 revision stapes surgeries performed from 1974 to 1992 were reviewed. Either the KTP or the argon laser was used in 40 operations. Prosthesis problems were the most common cause for revision (63%) followed by eroded/necrotic incus (29%) and adhesions (29%). Overall "success" in air-bone gap closure (air-bone gap < or = 10 dB) was 46% for first revisions and 33% for second or greater revisions. The "improvement" rate (air-bone gap < or = 20 dB) was 65% for first revisions and 53% for second or greater revisions. There was no statistically significant difference in hearing results between laser surgery and conventional technique. However, an absence of adhesions was noted when the laser had been used in the primary procedure.

Adolescent↗
PubMed2004

High-resolution X-ray computed tomographic scanning of the human stapes footplate.

OBJECTIVES: The mechanical behaviour of the footplate and its annular ligament depends critically on their shape and orientation in the oval window, but accurate measurements have been difficult to make owing to their small size. Our aims are to visualize the footplate at high resolution and understand its dynamics. METHODS: The human cadaver stapes footplate was dissected, and very high-resolution x-ray computed tomographic (CT) scans, with voxel sizes from 4 to 8 pm, were performed. Locally developed software was used to reconstruct the images. RESULTS: The data permit us to explore minor details of shape and orientation. The footplate looks like a footprint, and the annular ligament has variable thickness, with a cleft (groove) in its anterior attachment to the oval window. The CT data also permit us to create a three-dimensional finite-element model that can simulate footplate motion. CONCLUSIONS: The results obtained lead to further understanding of the mechanical behaviour of the footplate and the annular ligament.

Humans↗
PubMedDate not supplied

Active otosclerotic foci in the stapes. An electron microscopic study.

A total of 12 undecalcified and decalcified otosclerotic stapes containing active spongiotic lesions were examined using an electron microscope. Evidence of osteolytic osteolysis was seen in all specimens, but osteoclasts were observed in only four. The advancing front in the spongiotic lesion was 'moth-eaten' due to the demineralization of canaliculi and lacunae. The demineralizing process appeared to be initiated by degranulation of lysosomes by the degenerating osteocytes. As bone resorption continued, poorly mineralized new bone was laid down by osteoblasts which showed mitochondrial swelling. The possible implication of this mitochondrial swelling is discussed in relation to the pathology of the otosclerosis.

Ear Ossicles↗
PubMedDate not supplied

Results of stapes operations with preservation of the stapedius muscle tendon.

The material consisted of 195 operated otosclerotic ears. In 101 ears the stapedial tendon was left intact and in 94 ears it was divided. The follow-up period was approximately 8.0 years. The stapedius reflex was tested in 85 ears with intact tendon and in 25 with divided tendon. It was elicited in 50 of the former but in none of the latter. Both bone and air conduction thresholds were postoperatively poorer in ears with preserved tendon than in the ears with divided tendon. Revision surgery was performed in 19 ears, 13 of which had an intact stapedial tendon. The reason for reoperating was usually the fixation of the stapedial crus at the oval window margin. The crus may have shifted because of the pull exerted by the stapedial muscle. In spite of the better circulation to the stapes and the long process of the incus, and of possible protection against loud noises, we cannot, in the light of our experiences, recommend preservation of the stapedius muscle tendon.

Adolescent↗
PubMed1999

Congenital stapes ankylosis, broad thumbs, and hyperopia: report of a family and refinement of a syndrome.

We report on a family with conductive hearing loss due to congenital stapes ankylosis, and with hyperopia, broad thumbs, and broad first toes. Neither of the studied relatives had symphalangism, possibly distinguishing this syndrome as an entity separate from the facio-audio-symphalangism and proximal symphalangism syndromes. An alternative possibility is that this family falls within the spectrum of the facioaudio-symphalangism and proximal symphalangism syndromes. Visualization of the ossicular chain, and ophthalmologic and radiologic studies are important in the evaluation of families with congenital conductive hearing loss. A characteristic physiognomy in our patients is present; this autosomal dominant syndrome was first described by Teunissen and Cremers [1990: Laryngoscope 100:380-384].

Adult↗
PubMed1999

[Variations and incidents encountered during stapes surgery for otosclerosis].

The aim of this study was to report peroperative variations and incidents encountered during stapes surgery for otosclerosis, from a retrospective series of 293 primary stapedectomies performed in the ENT department of Fondation Adolphe de Rothschild, from january 1990 to december 1996. Pitfalls related to anomalous states or pathological conditions were observed in 81 cases (27.6%) and were classified as follow: narrow oval window niche (12.3%), floating footplate (5.8%), obliterative otosclerosis (4.7%), ossicular chain problems (3.4%), loss of perilymph and/or intravestibular bleeding (2.4%), fixed malleus (1%). Hearing results following surgery are presented. Because of the relatively high incidence of these unforeseen events, the otologic surgeon must be well trained and experienced to be able to use all reasonable stapedectomy or stapedotomy techniques.

Ear↗
PubMed1975

[Postoperative estimation of stapes- and tympanoplastics by pressure evoked threshold shift (author's transl)].

Postoperative middle ear function (tympano-and stapesplastics) is discussed by threshold shift caused by pressure evoked dislocation of the middle ear transmission system (tympano audiometry). The hearing ability in correlation with the tympanogram und tympano-audiogram of special cases out of a total of 91 patients is shown. Different types of tympano-and stapes plastics are discussed.

Audiometry↗
PubMed1976

On the oscillation behavior of the incus-stapes joint (author's transl).

A two-channel inductive measuring system in the human temporal bone preparation was used to oscillographically record oscillations of incus and stapes as well as to observe the phases between the two auditory ossicles at the same time. In the frequenzies between 300 and 1,200 Hz it was not possible to prove clearly a phase difference, in the higher frequency ranges (approximately from 2,000 Hz upwards), however, a phase difference was observed to occur regularly to an extent of 90 degrees and more.

Ear Ossicles↗