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[An atraumatic approach in stapes reconstruction].

In order to prevent complications which occur in classical stapedoplasty, authors applied a new atraumatic procedure in 138 patients with otosclerosis. Along with preserved ossicular chain, stapedotomy was performed and a piston-wire prosthesis placed. Disarticulation of incudostapedial joint was the next part of the procedure with removal of suprastructure of the stapes. Early and late cochlear disorders were rare while the final functional effects were much better. This paper analyzes numerous advantages of this procedure with directives for promotion of our work in the future.

Humans↗

The effect of stapes surgery on high frequency hearing in patients with otosclerosis.

OBJECTIVE: To assess the effect of stapedectomy on high frequency hearing. STUDY DESIGN: A retrospective, one-group, pretest-posttest case review was performed of the audiometric data of patients who underwent stapedectomy at a tertiary referral center. PATIENTS: Thirty-eight patients (40 ears) with primary uncomplicated surgery were selected. Twenty-two of the patients were older than 40 years. Preoperative and postoperative audiograms were analyzed. RESULTS: Preoperative and postoperative audiograms exhibited a down-sloping configuration toward the high frequencies. Surgery resulted in a significant improvement (p < 0.05) from 500 to 4000 Hz in air conduction and 500 to 2000 Hz in bone conduction. Analysis of variance showed that age had no bearing on preoperative audiometric results (p < 0.05) for air conduction, bone conduction, and the air bone gap. Postoperatively, younger patients' 4000 to 8000 Hz (air conduction) and 4000 Hz (bone conduction) were better than those of the older patients (p < 0.05), but the high frequency range was still poorer than age-matched controls in the younger patients. CONCLUSION: Stapedectomy resulted in significant closure of the air bone gap between 500 to 4000 Hz, but failed to influence hearing above 4000 Hz. Age appears to be an important variable; poorer results in the high frequency range were seen in the older patients who underwent stapes surgery. These findings, together with the residual postoperative hearing loss in the high frequency range in young patients, may reflect disease-specific injury resulting from cochlear otosclerosis.

Adult↗

Noninvasive assessment of the intralabyrinthine pressure. A new technique applied to patients with X-linked progressive mixed deafness syndrome with perilymphatic gusher during stapes surgery.

In this report, we describe the findings of a noninvasive assessment of the intralabyrinthine pressure in two patients from a family with X-linked progressive, mixed deafness syndrome in whom a perilymphatic gusher occurs during stapes surgery. The so-called tympanic membrane displacement measurement technique could be successfully applied in these two patients (from a total of five patients who were studied) because they still showed a stapedial reflex at 1 kHz, which is mandatory for application of the tympanic membrane displacement measurement technique. The findings were compared with those of age-related control subjects and indicated a significantly elevated intralabyrinthine pressure in the two patients who were observed. The results suggest that the tympanic membrane displacement measurement technique may serve as a screening test in audiological diagnostic studies of perilymphatic hypertension.

Acoustic Impedance Tests↗

Transcribed sequences encoded in the region involved in contiguous deletion syndrome that comprises X-linked stapes fixation and deafness.

We have used a direct cDNA selection protocol to isolate expressed sequences from yeast artificial chromosome clones that contain approximately 900 Kb of genomic DNA from Xq21 band that is deleted in contiguous gene syndromes comprising of mixed deafness associated with stapes fixation (DFN3). In addition to identifying Brn4 (POU3f4), a POU domain containing transcription factor that is involved in DFN3 phenotype, we have isolated seven short fragment cDNAs mapping to the deleted region. Some of the selected fragments showed X-chromosome specificity and hybridized to autosomal DNA fragments, indicating the presence of a low abundance interspersed repeat in the cDNAs or their homology to some uncharacterized family of genes. In conformity with the inertness of Xq21 band our results demonstrate that the region encodes far less than the average density of genes in other parts of the genome.

Branchio-Oto-Renal Syndrome↗

[Histological study of the binding of Polycel and Ceravital implants to the stapes footplate in rabbits].

Five Polycel and five Ceravital implants were interposed between the stapedial footplate and the tympanic membrane in 10 rabbits. Four to 7 months later the connection of the prostheses to the stapes was histologically examined by temporal bone sections. The union of both types of prostheses to the stapedial footplate was achieved by remnants of crura, middle ear mucosa and connective tissue. Histology revealed a more stable connection of the Polycel prosthesis to the stapedial footplate.

Animals↗