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At least 343 records · Page 19Linked to original sources
PubMed1997

[Isotopic studies on the regeneration of stapedial bone in otosclerosis].

The aim of the study was determining the bone rebuilding activity in stapes and otosclerotic focus and comparison the relation between bone rebuilding activity with some clinical features such as the patient's sex and age, duration of the disease and the degree of hearing impairment. The study covered 98 patients aged from 18 to 68 years (X = 37 years) in whom, due to otosclerosis, stapedectomy was performed at the Clinic of Otolaryngology--PAM in Szczecin. The rebuilding activity was estimated in bone fragments having been removed during the operation, i.e. in 98 specimens of canal wall bone, 97 specimens of stapedial crura, 88 fragments from posterior and 18 fragments from anterior parts of footplate as well as in 15 otosclerotic foci, using isotopic method implementing a complex of pyrophosphate labelled with technetium Tc-99m. The degree of bone rebuilding activity was defined by the amount of absorbed isotopic index. The "control group" was made up of 9 cases, in which stapedectomy was carried out for therapeutical purpose in consequence of other ailments, namely: in 3 cases of congenital stapedial ankylosis, 5 cases of stapedial tympanosclerosis, and 1 case of Menier's disease. It has been disclosed that otosclerosis is an active pathological process, involving the bone of the entire stapes with the strongest manifestation in the disease focus. An essential fact was linked with the very low bone rebuilding activity in the stapedial footplate and crura in the "control group". The bone rebuilding activity in otosclerotic foci and footplate of stapes was somewhat higher in males than in females. It was the highest in patients whose disease duration was the longest. In general the bone rebuilding activity didn't influence the degree of hearing impairment.

Adolescent↗
PubMed1998

[My adventure with otosclerosis].

The author presents his own experience in surgical treatment of otosclerosis in 373 patients. He particularly exposes results concerning hearing level after surgical procedures and discusses progress of symptoms which accompany otosclerosis like vertigo or dizziness and tinnitus in the context of bibliography data. He also looks at the complications occurring during procedures and following them. Worth noticing is presentation of long term results after 10-year follow-up.

Adolescent↗
PubMed1982

Type II collagen autoimmunity in otosclerosis and Meniere's Disease.

Antibodies to collagen types I, II, and IV were measured in patients with otosclerosis and patients with Meniere's disease. Levels of antibodies to type II collagen were significantly higher in these patients than in control subjects, while no differences were found among levels of antibodies to collagen type I or type IV. These observations suggest a possible role for type II collagen autoimmunity in the etiology of otosclerosis and Meniere's disease.

Autoantibodies↗
PubMed1975

Labyrinthine otosclerosis and sensorineural deafness. Pathologic findings of the spiral ligament.

In severe labyrinthine otosclerosis, spiral ligament changes occur predominantly adjacent to the stria vascularis, and consist of a decrease or loss of the capillary-perilymph system. It is suggested that this results in increased concentrations of metabolic products in the cochlear fluids that can no longer be absorbed effectively. If vascular shunts form they might represent collateral channels, with the flow of blood from the cochlea into the otosclerotic focus, bypassing the deficient capillary network in the spiral ligament. The zone of dense collagenization is described as a widening of the soft tissues endosteum of the cochlear capsule due to erosion of the bone, with the bone surface now set further back. This may result in greater mobility or loosening of the suspension mechanism of the basilar membrane.

Aged↗
PubMed1978

Cochlear reserve in otosclerosis. A long-term follow-up study of fenestration cases.

In this long-term follow-up study of fenestration cases, a remarkable stability in sensorineural hearing levels is demonstrated. Since the focus of otosclerosis was not removed at the time of fenestration surgery, this bone conduction stability is an indication that the ear can withstand the presence of an otosclerotic lesion that produces stapes fixation for long periods of time without sensorineural deterioration. It would seem that the otosclerotic lesion in ears suitable for fenestration surgery has had little tendency to invade deeply into the cochlear capsule.

Adult↗
PubMed2004

Proposed association between the COL1A1 and COL1A2 genes and otosclerosis is not supported by a case-control study in Spain.

Otosclerosis (OTSC) is one of the most common causes of hearing loss in white adults. The COL1A1 and COL1A2 genes coding for type-I collagen have been proposed as candidate genes in the development of OTSC. The COL1A1 gene was recently reported to be associated with the condition on the basis of a population-based case-control study. We report here an independent study of association between COL1A1 and COL1A2 gene polymorphisms and OTSC, in a case-control sample from a population of Caucasian individuals living in Northwest Spain. Specifically, we studied two COL1A1 polymorphisms previously reported to be associated with OTSC, and six COL1A2 polymorphisms. We performed diverse association analyses based on alleles, genotypes, and two-locus haplotypes. We found no evidence supporting the putative link of COL1A1 and COL1A2 genes with OTSC.

Adolescent↗
PubMed1990

Lasers for otosclerosis--which one if any and why.

Laboratory stapedotomy and stapedectomy revisions were performed in human temporal bones while pyroelectric wave energy analyzers and ultrasensitive thermocouples measured energy absorption at the stapes footplate and in the vestibule. Analysis of these data shows that the visible lasers (argon and KTP-532) possess ideal optical properties and precision for otosclerosis surgery but conversely have less than ideal tissue characteristics. The CO2 laser possesses ideal tissue characteristics. Recent advances in optical engineering and pulsing the energy have increased the precision of this laser to now provide the accuracy required for delicate microsurgery. Two clinical studies analyze the long-term hearing results and complications in patients who had undergone CO2 laser stapedectomy revision (59 patients) and CO2 laser stapedotomy (153 patients). The advantages that these laser techniques provide over conventional surgery methods are discussed.

Equipment Design↗
PubMed1983

Cathepsin-B activity in otosclerosis.

Cathepsin-B activity was determined fluorimetrically in the otosclerotic stapes footplate, the stapes superstructure, normal temporal cortical bone, and os frontale osteoma. Measurements with a synthetic substrate made determinations in individual samples possible. The cathepsin-B activity in the otosclerotic stapes footplate was one order of magnitude higher than that of the superstructure, which was not affected by the disease. The cortical bone and the superstructure displayed similar activities, as did os frontale osteoma and otosclerosis. The high lysosomal proteinase activity appears to be closely connected to the otosclerotic bone resorption process.

Cathepsin B↗
PubMed1980

A contribution to the pathogenesis of otosclerosis.

In a histochemical and electron microscopical study the pathogenesis of otosclerosis was investigated. The morphological changes in the extra- and intracellular space indicated a complex metabolic disturbance of all tissue components. The observed chondrocytic chondrolysis stressed the role of the cartilage remnants in the otic capsule as an etiological factor. There was morphological evidence of a superimposed enzymatic defect.

Cartilage↗
PubMed1977

[Active otosclerosis of the stapes footplate: histological and clinical aspects of its influence on the perilymph (author's transl)].

Pathologic capillaries are usually seen in the center of an otospongious process. Next to obliteration, dilatation and increased permeability a loss of basement membrane structure is evident. Around the capillaries exists a wide network of mesenchymal cells which have a glycogen like mass within the cytoplasm; glycogen can be delivered into the extracellular fluidspace. Free erythrocytes are located around many vessels. Near the margin of the lacunae decalcificated areas are seen; in the center of these areas osteocytes undergo lysis; they show intracytoplasmatic deposits of apatite which we assume to be located within the mitochondria. The collagen structure in the neighbourhood of the osteocytes seems to be damaged. Once the resorptive process has reached the perilymphatic surface of the footplate there comes to an connection between the otospongiotic lacunae and the vestibule. Free erythrocytes, glycogen like drops and lysosomes are delivered into the perilymph. Comparing the histological results with the operative results in patients with floride otosclerosis we conclude that operation should be done as early as possible to prevent damage from the inner ear, caused by the continuous intoxication of the perilymph from the otosclerotic focus.

Bone Resorption↗
PubMed1975

[Vascular degeneration in otosclerosis and its influence on the mesenchymal reaction of the mucoperiost].

38 samples of middle ear mucosa were taken from different patients during stapes surgery in otosclerosis. The samples were studied light-and electronmicroscopically without decalcification. Considerable pathologic changes in the organisation of the capillaries (endothelial hydrops, proliferation of the intima and of the adventitia, total obliteration o the vessels) cause pathologic reactions on the mesenchymal elements of the submucosa. Next to fibrolysis or hyalinosis of the collagen fibers the fibrocyts show features of undergoing lysis. Free and cellular bound calcium deposits are located in these lytic areas. The epithelial lining also shows unusual inclusions as glycogen and acid mucopolysaccharides and an alterated basement membrane. We belive that the changes of the connective tissue and of the epithelium are secundary to the capillary obstruction.

Apatites↗
PubMed1997

[Erosion and necrosis of the long process of the incus after otosclerosis operation].

The frequency and possible causes of erosion and necrosis of the long process of the incus induced by various types of prostheses following stapes surgery for otosclerosis are discussed. Between 1987 and 1995, 1144 stapes operations were performed including 117 revisions of stapes surgery performed by third parties and 27 revisions performed by the author. For the first time, necrosis of the long process of the incus caused by teflonplatinum piston is described on the basis of findings in five cases, in which the platinum loop had completely transmigrated the incudal process in a medial direction. By using pictures of the teflon-platinum piston and a gold piston taken by a scanning electron microscopy and a comparison between the use of a teflon-wire piston and a gold piston in two operations, an hypothesis is made that the winding grooves in the surface of the teflon shaft together with impaired middle ear mechanics were the main causes of a scar being contracted in the direction of the oval window niche with resulting necrosis of the incudal process. Requirements for an optimum stapes prosthesis are summarized as a result of the operative observations made.

Adult↗
PubMed1997

MRI of active otosclerosis.

Our aim was to determine whether MRI reliably shows pathology in patients with active otosclerosis (otospongiosis). We studied five patients with clinical and audiometric signs of this disorder and positive findings on high-resolution CT and tympanocochlear scintigraphy. Contrast enhancement of otospongiotic lesions was found in all affected ears, and could be topographically related to demineralised otospongiotic foci on CT. In lesions in the lateral wall of the labyrinth MRI sometimes showed the pathology better than CT, where partial-volume effects could be troublesome.

Adolescent↗
PubMed2002

Clinical consequences of feedback on ear surgery: the continuous recording of adverse events and complications with regard to reducing the number of surgeons who perform otosclerosis surgery.

Electronically stored data may be used to generate feedback overviews. This paper describes a method for establishing a picture of ear surgery complications. In this prospective study, the working definition of adverse events and complications is "incidents that are not intrinsic to the surgical procedure and that have a potential or actual negative effect on surgical outcome or postoperative morbidity". A simple method is used to categorise otologic adverse events and complications. This scale varies from adverse events (grade A) to death (grade D). All adverse events and complications in ear surgery that met this definition were documented electronically as part of continuous follow-up between 1 July 1992 and 30 June 1999. In the first 3 years, 1,009 ear operations were performed, and in 51 (5%) of them, adverse events or complications were noted during or after surgery. There were 30 (3%) grade A (adverse events), 18 (2%) grade B (minor complications), 3 (0.3%) grade C (major complications) and no grade D complications. Otosclerosis surgery was evaluated additionally, because halfway through a 7-year period, the number of surgeons was changed. Only three experienced, senior members of staff were involved, and inexperienced residents no longer were allowed to perform this kind of surgery. The reduction of surgeon numbers did indeed improve the outcome of the stapes surgery. Our results were comparable to the literature. This monitoring of outcome-results in relation to changes in care can be seen as a study of care quality. A review of this kind links daily clinical practice to the literature and induces an improvement in quality.

Adolescent↗
PubMed1999

Sex differences in patients with hearing impairments caused by otosclerosis.

The course of hearing in the non-operated ears was examined in 112 female patients and 63 male patients with bilateral otosclerosis who had operations in one ear only. All patients had a follow-up of at least 5 years. The mean annual impairment of the air conduction thresholds in the female patients (2.0-2.5 dB/year) did not differ significantly from that of the male patients (2.0-2.3 dB/ year). At the last follow-up examination, no difference was found between the sexes in the magnitude of the air-bone gaps. However, a sensorineural component developed in the women more frequently than in the men. Although at the last examination bone conduction thresholds of the female patients were significantly worse than those of the male patients, these were not matched by age.

Adult↗
PubMed2000

Tinnitus and otosclerosis.

Fifty patients with otosclerosis and tinnitus were studied for the course of the tinnitus after stapes surgery. Tinnitus disappeared in 64% of the cases, improved in 16%, was unchanged in 14%, and worsened in 6%. The reduction in tinnitus was more favorable after a small fenestra stapedotomy than after a partial stapedectomy with removal of the posterior half of the footplate. An unfavorable postoperative course of tinnitus did not appear to be linked to the postoperative audiometric result. In our study the subjective evaluation of pitch and loudness of the tinnitus did not provide significant information regarding its prognosis.

Adult↗
PubMed2003

Surgical treatment of otosclerosis in elderly patients.

OBJECTIVE: The aim of this study was to analyze hearing results of stapes surgery in otosclerotic patients older than 65 years. STUDY DESIGN: Among 473 primary stapedectomies, 16 were performed in patients over 65 years old and were retrospectively reviewed. Hearing results were compared with those of a randomly selected group of 16 patients younger than 65 years old. RESULTS: Improvement in hearing (closure of the air-bone gap to <20 dB) was achieved in all of the cases, and closure of the air-bone gap to less than 10 dB occurred in 87.5% at 1 month and in 81.8% at the last evaluation (mean follow-up, 19.5 months). Hearing results were similar in elderly and younger patients. CONCLUSION AND SIGNIFICANCE: Stapes surgery is an effective procedure in elderly patients with otosclerosis to avoid hearing aid use or to facilitate hearing aid fitting.

Adult↗