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At least 343 records · Page 19Linked to original sources
PubMed2003

Hearing results in stapes surgery using two different prosthesis.

AIM OF THE STUDY: Evaluation of hearing results after implantation of a fluoroplastic-platinum piston (FP) and of a titanium piston (T) with a shaft diameter of respectively 0.6 mm and 0.4 mm, in cases of otosclerosis requiring stapedotomy. MATERIAL AND METHODS: Pre-operative and post-operative hearing results obtained after primary stapedotomy by implantation of 30 FP and 30 T performed by the same expert author (C.Z.) were reviewed. In each patient we evaluated pre- and post-operative auditory thresholds, as recommended. RESULTS: All patients of both groups showed a significant air-bone gap (ABG) improvement for all frequencies after surgery ( P < 0. 001). Post-operative ABG comparison between the two groups showed a better ABG for lower frequencies in the FP group and for higher frequencies in the T group, but the difference was not significant. No post-operative complications, including sensorineural hearing loss, were found. Bone conduction improvement was better in the FP group than in the T one and this difference was statistically significant at 1000 and 2000 Hz. There was no statistically significant difference in the post-operative outcomes between the two prosthesis. Better results of FP for lower frequencies suggest that an increase in diameter of the prosthesis results in a greater improvement in the hearing threshold at low frequencies, while a decrease of diameter results in a greater improvement in the hearing threshold at high frequencies, as indicated by previous international studies. CONCLUSION: Our data shows that titanium piston is a as good as fluoroplastic piston in stapes surgery for otosclerosis.

Adult↗
PubMed2004

Outcome of stapes surgery for otosclerosis.

Otosclerosis is an autosomal dominant disease affecting the otic capsule. It is believed to be rare in Asian countries including Malaysia. We analyzed the results of 29 patients (35 ears) who had undergone stapes surgery for suspected otosclerosis from January 1996 to June 2002. The demographic data was analyzed. The procedure most commonly performed was stapedotomy. The closure of air bone gap after surgery was good at 2 kHz and 4 kHz compared to frequency below 2 kHz. Closure of air bone gap to within 10 dB was achieved in 74.3%. About 7.5% of our patients did not gain in average air conduction. The outcome of the procedure is comparable to those reported by authors who used the same evaluation criteria. No serious complications occurred in our patients.

Adult↗
PubMed2004

Long-term follow-up of tinnitus in patients with otosclerosis after stapes surgery.

We prospectively studied 48 otosclerosis patients over a 2-year interval. Forty-four had stapedotomy, and four had stapedectomy. Demographics, clinical history, and pre- and postoperative audiometry results were recorded. A questionnaire asking about tinnitus (intensity, pitch) and including a visual analog scale quantifying the degree (1-10) of annoyance caused by the tinnitus was completed pre- and postoperatively (4-10 months and 14-48 months, respectively). Ninety-one percent of the otosclerosis patients reported the presence of tinnitus, and 39.58% reported severe disabling tinnitus (SDT; 7-10 on the visual analog scale). High-pitch (whistle) tinnitus was present in most patients, and white noise (radio static, waterfall, rain) was present in others. No patient described the tinnitus as a low-tone noise (buzzing). Ninety-one percent of patients reported tinnitus reduction or total remission after surgery. Ten of 19 patients with SDT reported complete remission of tinnitus, 7 reported improvement postoperatively, and 2 reported no change. No patient reported worsening of tinnitus. Small postoperative air-bone gaps (four tonal average) correlated with remission or reduction of tinnitus in SDT patients. Tinnitus pitch, gender, and age of patients were not related to decrease of tinnitus postoperatively. A larger preoperative air-bone gap correlated with larger reduction of tinnitus after successful surgery. A lower preoperative bone conduction level correlated with more intense tinnitus before surgery and greater reduction postoperatively. We contacted 25 patients from 14 to 48 months after surgery, and all reported that their tinnitus status had not changed since the early follow-up. Tinnitus is very prevalent in otosclerosis patients; almost one-half of patients have SDT preoperatively, and stapes surgery improves this symptom in 91% of cases. Preoperative air-bone gap and bone conduction level and a postoperative airbone gap seem to influence the degree of postoperative tinnitus reduction.

Adolescent↗
PubMed2005

[Long-term results of stapes surgery--over 1000 patients].

Authors present audiometric results of 1200 patients with otosclerosis post stapedotomy. Air-conduction, bone-conduction and air-bone gap was measured prior the surgery and 12 months post stapedotomy for frequencies 0.5, 1.0, 2.0 and 3.0 kHz. In the analysed group of 1200 patients a postoperative air-bone gap 0-10 and 11-20 dB was obtained in 93.7% patients. The result of stapedotomy in reference to tinnitus based on the patients' subjective opinion showed that 78.0% patients were either free from tinnitus or tinnitus was subjectively decreased. Authors stress that some anatomical abnormalities in the tympanic cavity might influence on the result of stapes surgery.

Audiometry, Pure-Tone↗
PubMed1991

Elastic-related fibers in the annular ligament of the stapes-oval window articulation. An electron microscopic and histochemical study in the rat and the rabbit.

The annular ligament that attaches the circumference of the base of the stapes to the margin of the oval window (fenestra vestibuli) was stained with selective methods for elastic system fibers and was also studied at the ultrastructural level after tannic acid-glutaraldehyde fixation. Although the annular ligament is devoid of elastic fibers, it is rich in elastic-related fibers (i.e. = oxytalan and elaunin fibers). Elaunin fibers predominate in the annular ligament itself and they are continuous with the oxytalan fibers which are embedded in the matrix of the articular cartilage.

Animals↗
PubMed1989

Choroideremia and deafness with stapes fixation: a contiguous gene deletion syndrome in Xq21.

The study of contiguous gene deletion syndromes by using reverse genetic techniques provides a powerful tool for precisely defining the map location of the genes involved. We have made use of individuals with overlapping deletions producing choroideremia as part of a complex phenotype, to define the boundaries on the X chromosome for this gene, as well as for X-linked mixed deafness with perilymphatic gusher (DFN3). Two patients with deletions and choroideremia are affected by an X-linked mixed conductive/sensorineural deafness; one patient, XL-62, was confirmed at surgery to have DFN3, while the other patient, XL-45, is suspected clinically to have the same disorder. A third choroideremia deletion patient, MBU, has normal hearing. Patient XL-62 has a cytogenetically detectable deletion that was measured to be 7.7% of the X chromosome by dual laser flow cytometry; the other patient, XL-45, has a cytogenetically undetectable deletion that measures only 3.3% of the X chromosome. We have produced a physical map of the X-chromosome region containing choroideremia and DFN3 by using routine Southern blotting, chromosome walking and jumping techniques, and long-range restriction mapping to generate and link anonymous DNA sequences in this region. DXS232 and DXS233 are located within 450 kb of each other on the same SfiI and MluI fragments and share partial SalI fragments of 750 and greater than 1,000 kb but are separated by at least one SalI site. In addition, DXS232, which lies outside the MBU deletion, detects the proximal breakpoint of this deletion. We have isolated two new anonymous DNA sequences by chromosome jumping from DXS233; one of these detects a new SfiI fragment distal to DXS233 in the direction of the choroideremia gene, while the other jump clone is proximal to DXS233 and detects a new polymorphism. These data refine the map around the loci for choroideremia and for mixed deafness with stapes fixation and will provide points from which to isolate candidate gene sequences for these disorders.

Adolescent↗
PubMed1988

[Movements of stapes-piston prostheses in changes in static air pressure].

The displacements of stapes piston prostheses, induced by variations of static air pressure from 0 to +/- 400 mm H2O, were examined in 9 temporal bone preparations by a microscopic measuring method. In the normal middle ear, the gliding incudo-malleal joint, serving as a protective mechanism, confined these movements to a mean of 232 microns. These in- and excursions could exceed 0.5 mm, however, with an ankylosed incudo-malleal joint. Arthrosis of this joint is not rare in otosclerosis. In view of these excessive displacements, compared to inner ear dimensions, piston prostheses should always dip into the vestibulum in the lower half of the footplate, far from endolymphatic membranes. A simple technique may intraoperatively reveal the gliding or ankylosed condition of incudo-malleal joint surfaces, prior to adapting the length of the prosthesis.

Acoustic Impedance Tests↗
PubMed1986

[Stapes anomaly, Gorlin-Goltz and hand-foot-uterus syndrome as partial aspects of a generalized ectodermal-mesodermal abnormality syndrome with variable expression].

A case of a Gorlin-Goltz-syndrome with anomalies of the stapes and incus of one ear is described for the first time. In the reported case, the hand-foot-uterus-syndrome could be recognised simultaneously. In the literature, about 250 cases of the syndrome are known, first published by Gorlin and Goltz in 1960. Malformations of the middle ear, however, have not yet been described in the Gorlin-Goltz-syndrome. As in the reported case both of the syndromes, the Gorlin-Goltz-syndrome and the hand-foot-uterus-syndrome, could be diagnosed, it must be discussed whether there are two independent syndromes or only one syndrome of polyvalent malformations characterised by variable expressivity.

Adult↗
PubMed1985

[Normal position of the stapes in the oval window niche in man].

A study of mastoid bones showed a central position of stapes only at 67%. At 21% a deviation exist to the side of promontorium and at 12% a position directly at the promontorium. Secondly is to remark the position of the posterior crus incudis lateral on the footplate to the side of promontorium. The cause is to see the movement of the labyrinth in connection with the upright posture.

Ear Ossicles↗
PubMed1985

Pneumocephalus following treatment of a stapes gusher.

A case history is presented of a patient who underwent stapedectomy complicated by a cerebrospinal fluid (CSF) gusher. A persistent postoperative CSF leak was controlled by elevation of the head and spinal drainage. Retrograde passage of air through a labyrinthine fistula, however, resulted in pneumocephalus and transient neurologic deficit. This is a rare but serious complication of treatment of a stapes gusher which demonstrates the potential for entry of air intracranially in the presence of a perilymph fistula.

Adult↗
PubMed1978

[Recurrent meningitis and cerebrospinal fluid fistula across the footplate of the stapes].

The clinical observation of a patient who presented an association of recurrent meningitis, unilateral deafness, and congenital anomaly of the ear is presented. The surgical exploration permitted us to find a CSF leak through the footplate of the stapes. The present concepts concerning especially the diagnosis and treatment of this pathology are discussed.

Abnormalities, Multiple↗
PubMed1982

The missing stapes and the Tabor prosthesis.

This is a description of a new stapes replacement prosthesis (SRP), which we term "Tabor". The prosthesis has two parts--the lower part is made of a broad inorganic, biocompatible material (Teflon) base, which fits and covers most of the footplate, ensuring maximal stability. The upper part of the prosthesis is made of autograft or homograft bone--usually a malleus head, the contact of which with the drum prevents extrusion. Eleven out of 12 ears operated with this prosthesis were successful--the average postoperative air conduction going up 33 dB (15-50), leaving an average of 18 dB (5-30) air-bone gap. The bone conduction also improved, from an average of 21 dB (10-30) to an average of 14 dB (10-25).

Bone Transplantation↗
PubMed1993

Stapes surgery: subjective and objective results revisited.

In 1980 we presented a retrospective review of one surgeon's experience with stapes surgery. The results were disappointing both from the standpoint of hearing results and patient satisfaction. Because of those findings we modified both indications for surgery and our surgical technique. A second subjective and objective review was carried out between 1980 and 1992. We are pleased to report that both the subjective and objective findings are markedly improved, but there is still room for further improvement and our surgical technique will again be modified.

Audiometry, Pure-Tone↗
PubMed1995

Air-bone gap in patients with X-linked stapes gusher syndrome.

It is often possible to elicit the stapedius reflex in patients suffering from recessive X-linked progressive mixed deafness syndrome with stapes gusher. The presence of an air-bone gap in the audiogram and the ability to elicit the stapedius reflex are conflicting. Measurements were performed on two patients who were suffering from this syndrome, to establish whether the hearing loss was of the mixed or purely sensorineural type. It was argued that, owing to congenital malformations, the audiovestibular system might act as a more than normally efficient transducer, to convert skull vibrations into inner ear fluid motions, leading to bone conduction thresholds that are better than expected. The results of tone and speech audiometry, stapedius reflex measurements, and brainstem evoked response audiometry in this study showed a pattern similar to that generally seen in patients with purely sensorineural hearing loss. This supports the hypothesis that the air-bone gap in the audiogram does not have the usual significance of a conductive hearing loss component.

Adult↗
PubMed1996

[A comparison of the morphology of mammalian and bird ear ossicles and reflections on the asymmetrical form of the human stapes arch].

BACKGROUND: The human middle ear presents some anatomical detail which can not be explained exclusively by sound transmission (joints, muscles). These details can be interpreted as an adaptation to environmental atmospheric pressure loads. In order to further investigate the influence of these non-acoustic loads on the geometry of the middle ear structures, the ossicles of animals from different environments were examined. METHODS: In the first half of our century, the zoologist C. F. Werner collected the ossicles of 175 species, mostly mammals and birds. This collection was now cataloged and analysed with light and x-ray microscopy. RESULTS AND DISCUSSION: The diversity in size and design of the ossicles seems to be influenced not only by the acoustic environment of the animal--the ossicles of mammals living in the desert are relatively large, reflecting the better sensitivity of their middle ear for the far traveling low frequencies--but especially the bony structure of the ossicles can be related to the static loads of the environment of the animal. Ossicles of aquatic mammals are more solid and denser than in terrestrial forms. The bony structure aligns to the static load. This structural principle forms the basis of the skeleton and muscles and can also be found in the human stapes: the asymmetry of the stapedial arch can be explained as adaptation of the bony structure to the pull of the stapedius muscle. CONCLUSIONS: The anatomical structure of the ossicles of human and animal origin is not only influenced by its function as sound transmitter, but it is also shaped by nonacoustic forces and static loads of the environment.

Animals↗
PubMed1996

Traumatic luxation of the stapes evidenced by high-resolution CT.

We encountered a case of acquired perilymphatic fistula in which the origin of the disease, namely, the stapes begin medially displaced into the vestibule, was shown by thin-section CT. Accordingly, we recommend that every patient with suspected perilymphatic fistula of traumatic origin undergo high-resolution CT of the petrous bone.

Female↗