Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “OTOSCLEROSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed2001

Malleostapedotomy in revision surgery for otosclerosis.

PURPOSE: The purpose of this study was to analyze the results of malleostapedotomy and to compare them with those of a conventional incus stapedotomy in a series of 82 consecutive surgical revisions in otosclerotic patients. MATERIALS AND METHODS: 82 consecutive revision stapes surgery cases over 5 years were evaluated. The preoperative and postoperative audiometric data of 80 (97.5%) of the patients were obtained. RESULTS: 71 of the patients underwent a functional revision procedure as malleostapedotomy (56, 79%) or as incus stapedotomy (15, 21%). The most common cause of failure of primary surgery was a displaced or malfunctioning prosthesis (86.2%). Pathologic changes of the oval window were found in 80% of the cases. Problems of the incus were identified in 80% and abnormality of the malleus in 48.6% of the cases. The functional success rate of malleostapedotomy (closure within 10 dB) was found to be higher than that of traditional incus stapedotomy (p < 0.05). Overclosure was seen in 12 patients (17%) and a significant sensorineural hearing loss in 2 patients (3%). There were no dead ears in this series. The postoperative hearing results after first revision surgery were better than those after multiple surgical procedures (p < 0.05). CONCLUSIONS: Malleostapedotomy yields better functional hearing results than incus stapedotomy in revision surgery for otosclerosis. The detection of many malleus fixations was the result of the systematic exposure of the anterior malleal process and ligament through an endaural approach with superior canaloplasty.

Adult↗
PubMed2003

Characteristics and postoperative course of tinnitus in otosclerosis.

OBJECTIVE: The aim of this study was to determine the incidence and characteristics of tinnitus in otosclerosis and to evaluate the effects of stapes surgery on the course of this symptom. SETTING: Hospital ear, nose, and throat department. PATIENTS AND DESIGN: Sixty-two patients (65 ears) scheduled to undergo stapes surgery were prospectively enrolled in the study. The incidence and characteristics of tinnitus were recorded using a specific questionnaire before surgery and 1 and 6 months after surgery. The frequency range of the tinnitus was noted during standard audiometric examination. Audiometric data were recorded following AAO-HNS guidelines. INTERVENTION: All patients underwent stapes surgery (either stapedectomy or stapedotomy). RESULTS: Tinnitus was present at the time of surgery in 74% of the patients. It was severely disabling for patients in 24.6% of the cases. In patients who were preoperatively free of tinnitus, no tinnitus was noted in the postoperative period (1 and 6 months). In patients with preoperative tinnitus, tinnitus ceased in 55.9%, decreased in 32.4%, remained the same in 8.8%, and increased in 2.9% 6 months after surgery. Statistical analysis did not reveal any significant prognostic factors regarding the course of tinnitus. CONCLUSIONS: In otosclerotic patients who will undergo stapedectomy to improve hearing, stapes surgery may also improve tinnitus in most of them.

Adult↗
PubMed2005

Success rate in revision stapes surgery for otosclerosis.

OBJECTIVE: The aim of this study was to evaluate the hearing results of revision stapes surgery performed because of previously failed operations and to determine the causes of failure. STUDY DESIGN: Retrospective review of revision stapes operations. SETTING: Tertiary referral center. PATIENTS: Sixty-three consecutive revision stapes operations were performed in 56 patients over a period of 12 years (1992-2004). The indication for revision surgery was recurrent or persistent air-bone gap greater than 20 dB after primary surgical treatment of otosclerosis of the oval window. RESULTS: All patients were operated on to improve hearing. Sixty-three revision stapes operations resulted in closure of the air-bone gap to 10 dB or less in 52.4% of cases. The average postoperative air-bone gap was 13.1 dB, and the mean pure-tone average improvement was 12.9 dB. In six patients (9.5%), revision surgery produced no change in hearing, and in four (6.3%) the hearing decreased by 5 dB or more. In one patient, the operation resulted in a profound hearing loss. Prosthesis malfunction was the most common primary cause of failure (60.3%). The original prosthesis was replaced with a new one in 48 cases. In 30 of these (62.5%), closure of the air-bone gap to within 10 dB was achieved. In 15 cases, the prosthesis was not replaced, and in only four of these (26.7%), closure of the air-bone gap within 10 dB was obtained (p < 0.022). CONCLUSION: Revision stapes surgery is less likely to be successful than the primary operation. Closure of the air-bone gap to within 10 dB was achieved in 52.4% of patients. The success rate was better in cases where the original prosthesis was replaced with a new one. The risk for decreased bone-conduction threshold does not seem to be higher than in primary surgery.

Adolescent↗
PubMed2005

Shape-memory stapes prosthesis for otosclerosis surgery.

OBJECTIVES: The aim of this study was to determine the efficacy of a shape-memory alloy, Nitinol, as a component of an improved stapes prosthesis. STUDY DESIGN: Prospective laboratory and clinical study to develop a Nitinol stapes prosthesis. METHODS: Various diameters of Nitinol wire and temperature transition variants were analyzed with regard to ease of deformation, response to heating, and strength. The size and geometry of the closed hook was determined by measurement of 50 incus cadaver bones. Several heat sources for activating the shape memory were evaluated, including electrocautery, lasers, and warm water. Trial surgeries were then performed on human temporal bones in the laboratory. The closure characteristics of the Nitinol loop were studied. Magnetic resonance imaging (MRI) testing at 1.5 Tesla was performed to determine safety during MRI studies. Preliminary human subject trials were then instituted. RESULTS: In all cases, a low heat condition was ample to activate the shape memory characteristics of the hook and return it to a closed position after it had been opened. Laser power was generally set well below the power needed for removing bone. The Nitinol loop closed snugly around the incus with application to the top of the hook with a low temperature laser setting. Almost any heat source was effective. MRI testing at 1.5 Tesla showed no movement of the prosthesis. Preliminary results in human subjects showed excellent air-bone closure. The Nitinol loop holds uniform contact around the incus. CONCLUSIONS: The Nitinol piston greatly simplifies the stapedectomy procedure by taking the need for a hand operated instrument out of the surgeon's hands. Because of the nature of the Nitinol wire, it can never over-crimp. All these characteristics make the prosthesis advantageous for otosclerosis surgery.

Alloys↗
PubMed1979

Otosclerosis and pregnancy: a study of the influence of pregnancy on the hearing threshold before and after stapedectomy.

In a retrospective study of 144 fertile women subjected to operation for otosclerosis by the method of Shea or House, we found a fall in the hearing threshold in the operated ear which seemed to be a little greater in the patients who became pregnant after the operation than in those who did not. However, the hearing loss was significantly greater in the non-operated ear in the patients who became pregnant after the operation than in those who did not.

Adolescent↗
PubMed1994

Revision surgery in otosclerosis--operative findings in 186 patients.

Over a 14-year-period 186 revision operations for otosclerosis were performed. In 90% of the patients the indication for revision was too large an air-bone-gap. A number of different surgical techniques had been used at the primary operation. The purpose of the investigation was to describe the middle ear abnormality at the revision operation. Most often adhesions, acentric prosthesis, reobliteration and necrosis of the long process of the incus were found. The middle ear abnormality found at revision operation was correlated to the primary surgical technique used and the information obtained can be of value, when a revision operation is considered. The surgical technique used at revision operation was determined by the operative findings. The best hearing improvement was obtained when a small-fenestration-technique was used primarily or as the method for revision. In revision stapes surgery, the experience of the surgeon is important and centralization of this type of operation is recommended.

Ear Ossicles↗
PubMed1985

Cochlear otosclerosis (otospongiosis): CT analysis with audiometric correlation.

Ninety patients who had suspected or confirmed fenestral or cochlear otosclerosis underwent CT examination. Foci of demineralization in the otic capsule were discovered in 20 ears (12 patients). Audiometric studies of the 12 patients revealed sensorineural hearing loss (SNHL) with distinct correlation of CT findings with progressivity and with involvement of the frequency level subtended by the specific area of the cochlea involved. Foci of abnormal increased density, presumably representing the healed phase of this disorder, were found less frequently than expected. There was a predilection for the basilar turn. All patients had static SNHL in the higher frequencies. The healed phase of this disorder is probably not consistently diagnosable with CT.

Adult↗
PubMedDate not supplied

Magnetic resonance imaging and high-resolution computed tomography in the otospongiotic phase of otosclerosis.

Otosclerosis very often leads to severe hearing loss in a chronic progressive manner. In the first phase of the disease, otospongiosis causes an inflammatory osteolytic process in the osseous labyrinthine capsule. In the cases reported here, this osteolytic process was pronounced in the osseous capsule of the cochlea. High-resolution CT and MRI showed the precise localization and stage of this inflammatory-osteolytic process in the petrous bone, while scintigraphy confirmed the diagnosis.

Adult↗
PubMed1983

Ceruminous glands in otosclerosis. A histopathological and histochemical study.

The ceruminous glands of the external auditory canal skin of 20 patients suffering from otosclerosis were examined histologically and histochemically. The histological changes included flattening of the lining cells and widening of the lumina of the glands. Histochemical alterations were in the form of diminished succinic dehydrogenase, alpha esterase and alkaline phosphatase enzyme activities. The histological and histochemical changes indicated that atrophy of the ceruminous glands with diminished wax production occurred in some otosclerotic patients. This atrophy may be secondary to the involvement of the ground substance, vessels and nerves of the external auditory canal by the same etiologic factor responsible for the pathogenesis of the otosclerotic process.

Cerumen↗
PubMed1987

Proteolytic enzymes in otosclerosis. Significance of proteolytic enzymes in otosclerotic bone remodelling.

The otosclerotic stapes footplate exhibits higher activities of cathepsin D and H and collagenase-like peptidase than those of normal cortical bone. The elevated enzyme activities of osteoblastic origin (Cl-peptidase and cathepsin D) emphasize the essential and probably primary role of the bone-forming cells, not only in bone formation, but in resorption as well. The highest activity of cathepsin D from among the measured enzymes highlights the adjuvant role of acidic glucosaminoglycans in the otosclerotic demineralization process. As the osteoblastic osteoid synthesis is known to be sharply reduced in otosclerotic bone remodelling, and the above data emphasize the role of proteolytic enzymes of osteoblastic origin too, indirectly, osteoblasts seem to be the otosclerosis signal-transducing cells.

Bone Development↗
PubMed1988

Persistent stapedial artery associated with otosclerosis.

A 43-year-old female had bilateral otosclerosis with a persistent stapedial artery in the left ear which measured approximately 0.4 mm in diameter, lying on the floor of the tympanic cavity, running between the crura of the stapes and entering the facial canal. Stapedectomy was performed following section of this vessel and controlling the hemorrhage. Satisfactory hearing gain was obtained in both ears after stapedectomy.

Adult↗
PubMed1992

Candida and stapedial otosclerosis: histopathological findings.

The stapes of 6 patients with stapedial otosclerosis was found to contain fungus hyphae (Candida) in the sectioned specimens. The footplate of all cases and the head of the stapes in 2 of the cases revealed single or multiple erosion cavities containing numerous thin branching PAS-positive fungus hyphae with swollen terminal endings and scanty blastospores. Osteoclasts were not observed; occasional osteoblasts, blue mantles and otosclerotic foci were seen. Four patients had been treated for several years with antibiotics and corticosteroids for recurrent serous otitis media and 1 patient had had frequent catheterization of the eustachian tube. It may be suggested that the Candida infection was a secondary event induced by a general and/or local immunodepressed condition.

Adolescent↗
PubMed2005

Otosclerosis: incidence of positive findings on high-resolution computed tomography and their correlation to audiological test data.

OBJECTIVES: Computed tomographic (CT) scanning with slices of 1 mm or more has not been sufficient to demonstrate otosclerotic foci in most cases to date. METHODS: We investigated the validity of CT scans with a 0.5-mm cubical scan technique, with and without planar reconstruction, and correlated these findings with audiological data. Forty-four temporal bone CT scans from 30 patients with conductive or mixed hearing loss were evaluated. RESULTS: Otosclerotic foci were visualized in 74% of the cases. With reconstruction at the workstation, the sensitivity increased to 85%. Whereas in fenestral otosclerosis a correlation was found between the size of the focus and the air-bone gap, no correlation was seen between the size of the focus and bone conduction thresholds with cochlear involvement. Otosclerotic foci in patients treated with sodium fluoride were smaller than those in patients without treatment. This finding may indicate a beneficial effect of sodium fluoride on otosclerotic growth. CONCLUSIONS: High-resolution CT scans are a valid tool that can be used to confirm, localize, and determine the size of clinically suspected otosclerotic foci.

Adolescent↗
PubMedDate not supplied

Histopathological observations on the cochlear changes in otosclerosis.

Alterations in the dimensions of the basilar membrane and spiral ligament have been implicated in the pathogenesis of sensorineural hearing loss in otosclerosis. The histopathological findings in nineteen temporal bones with otosclerotic involvement of the cochlear endosteum are reviewed. Hyalinization and decrease in the width of the spiral ligament are the only consistent findings related to the otosclerotic focus in these temporal bones. The width of the basilar membrane is normal. The hair cell population and the stria vascularis are normal for the age group.

Atrophy↗
PubMedDate not supplied

Juvenile otosclerosis. A 20-year study.

An in-depth study of 610 patients who developed clinical otosclerosis before the age of 18 is reported; this is 15.1% of the total number of stapedectomy cases performed within the period 1961 to 1981. The study illustrates differences noted in those patients who had surgery performed before age 18 and those whose surgery was performed after age 18. These differences will be analyzed with respect to sex, family history, bilaterality, preoperative cochlear reserve, stapes footplate pathology, type of footplate surgery, and postoperative hearing results, as well as the follow-up for delayed complications and delayed hearing losses. Statistical data supports the hypothesis that there is no contraindication to performing stapedectomy surgery in children. This study demonstrates that the success rate is significantly higher in the under-age-18 group and correlates closely with the less severe footplate pathology encountered in children.

Adolescent↗
PubMedDate not supplied

Etiopathogenesis of otosclerosis: a hypothesis.

It is hypothesized that otosclerosis is an autoimmune disease in response to native type II collagens of cartilage rests associated with globular ossei in the endochondral layer of the otic capsule. To support this hypothesis animal experimental data and human antibody data are shown.

Animals↗
PubMedDate not supplied

Osteoclasts in chronic otitis media, cholesteatoma, and otosclerosis.

Bone resorption and remodeling are characteristic of chronic otitis media with and without cholesteatoma and otosclerosis. The consequences of this remodeling process may be hearing loss, repeated infection, vestibular disturbance, or intracranial complications. Evidence of osteoclastic bone resorption was found in surgical specimens of 11 of 24 cases of cholesteatoma, two of three cases of chronic otitis media, and three of ten cases of otosclerotic stapes; all three spongiotic lesions had osteoclasts. With careful serial sectioning these cells are almost always multinucleate and have the typical appearance of osteoclasts with ruffled borders. Some specimens had evidence of bone erosion in the absence of osteoclasts; this finding represents an inactive phase of the remodeling process. Since the osteoclast plays an important role in the resorption and remodeling of bone in these middle ear diseases, the source, physiology, and local control of these cells are of prime importance in investigating the pathophysiology of these diseases. At the present time, the local control of activation and recruitment of osteoclasts, as well as their chemotactic responses, is poorly understood.

Bone Resorption↗
PubMed1989

Mastoid pneumatization in otosclerosis.

The extent of mastoid pneumatization in 150 otosclerotic ears was compared with that of 150 healthy control ears. The size of mastoid pneumatization was measured by use of the Schüller lateral x-ray projection with the help of computed planimetry. The measurements showed the average pneumatized area in otosclerotic ears to be 17.4 +/- 5 cm2, in contrast to 12.9 +/- 4 cm2 for the healthy control ears. The difference between the two groups was highly significant (p less than .0001). While both groups showed a bell-shaped distribution of the measured pneumatized area, the curve of the otosclerotic ears was shifted significantly to the right. Our findings indicate a link between otosclerosis on the one hand and highly pneumatized mastoids on the other. This link between a hereditary disease and a specific type of pneumatization points to the likelihood that heredity also plays some role in determining the final type of pneumatization.

Adult↗