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At least 415 records · Page 23Linked to original sources
PubMed1993

Mechanics of the middle ear in otosclerosis and stapedoplasty.

Seventy-three otosclerotic patients, 138 subjects who had undergone stapes surgery (50 total stapedectomies, 43 stapedotomies with stapedius tendon section and 45 stapedotomies with stapedius tendon preservation) and 70 normal controls were investigated by susceptance multiple frequency tympanometry. The aims were to evaluate the efficiency of this procedure in diagnosing otosclerosis and to assess the resonance properties of middle ears undergoing different types of stapedectomy. Tympanometry was performed using sweep frequencies ranging from 226 to 2,000 Hz for each pressure step of 12.5 daPa (pressure range from -500 to 400 daPa). The resonance frequency of the system was evaluated by identifying the "W" morphology of susceptance tympanograms. The results of the present investigation indicate that stapes surgery abnormally reduces the stiffness of the tympano-ossicular system. This phenomenon is limited by preservation of the stapedius tendon, which confers a significant degree of stiffness on the conductive system.

Acoustic Impedance Tests↗
PubMed1996

The effect of drinking water fluoridation on the natural course of hearing in patients with otosclerosis.

The effect of drinking water fluoridation on the course of hearing of non-operated otosclerotic ears was assessed in an area where the natural waters have a very low fluoride content. The study population consisted of 150 patients with surgically proven otosclerosis. Patients having an additional known cause of hearing loss were excluded from the study. Every patient had a follow-up of at least 5 years, the mean follow-up period being 8.8 years. At last follow-up examination, air conduction thresholds of patients drinking fluoridated tap water were found to be significantly better than those of patients drinking fluoride-poor water, likewise there were significant differences in bone conduction thresholds at 1, 2, and 4 kHz. It was concluded that drinking water fluoridation has a beneficial effect on hearing levels of non-operated otosclerotic ears.

Adult↗
PubMed1997

Hearing results in otosclerosis surgery after partial stapedectomy, total stapedectomy and stapedotomy.

Hearing results in a consecutive series of 407 patients with otosclerosis undergoing primary stapes surgery were analysed (437 operated ears). Partial stapedectomy was performed in 70 ears (16%), total stapedectomy in 205 ears (47%), in both groups using the House steel wire prosthesis on fascia in the oval window. The remaining 162 ears (37%) underwent stapedotomy using the Fisch 0.4 mm teflon-platinum piston. No case of cochlear loss (> 15 dB) occurred in the total series. The comparison between the three groups one year postoperatively showed that the air-bone gap was smaller for partial and total stapedectomy for all frequencies except 4 kHz. The air-bone gap was calculated as the difference between the preoperative bone conduction and the postoperative air conduction thresholds. Partial and total stapedectomy also showed larger improvements of bone conduction thresholds compared with stapedotomy for all frequencies but 4 kHz. At the 3-year follow-up, the hearing gain for all frequencies (250-8000 Hz) was larger for partial and total stapedectomy. Yet, when comparing the decline of hearing from 1 to 3 year postoperatively, the hearing gain achieved with partial and total stapedectomy seemed to deteriorate at a higher rate, which was considered to be caused by impaired sensorineural function. Our results show that in the short-term perspective partial or total stapedectomy can still compete for better hearing results even at higher frequencies, but stapedotomy seems to yield more stable hearing results over time and should therefore be considered as the method of choice.

Adolescent↗
PubMed1997

From posterior crus stapedectomy to 0.6 mm stapedotomy--towards reliability in otosclerosis surgery.

In the 1980s, in Oulu, clinical otosclerosis was primarily managed with posterior crus stapedectomy and in the 1990s, the method was changed to stapedotomy. This retrospective study was carried out to assess the results of different methods of stapes surgery in the hands of one surgeon. Subsequent primary stapes operations in 1989-1990 (91 operations including 74 posterior crus stapedectomies and 1 Causse stapedotomy) and in 1993-1994 (117 operations including 1 posterior crus stapedectomy, 95 Causse pistons) were analysed. Changes in air and bone conduction thresholds were compared 5 weeks, 7 months and 19 or more months postoperatively. There was a significant difference in hearing (air-conduction-AC and bone-conduction-BC) in favor of Causse 0.6 mm teflon piston prostheses as compared to posterior crus stapedotomies at 7 months and 19 or more months. Likewise, the 4 kHz gain at the same time was also significantly better with Causse 0.6 mm all teflon piston. At 5 weeks, 81% of posterior crus stapedectomies and 78% of Causse stapedotomies had air conduction thresholds within 10 dB of preoperative bone conduction. However, at 7 months, the corresponding figures were 68% and 89%. Re-operations were performed in 26.7% posterior crus stapedectomies but only in 1% Causse 0.6 mm teflon piston stapedotomies. In the hands of the senior author (KL), the change from posterior crus stapedectomy technique to stapedotomy with 0.6 mm Causse teflon piston in primary stapes surgery proved to be successful. Surprisingly, the AC and BC hearing in the Causse stapedotomy group kept on improving during the follow-up.

Follow-Up Studies↗
PubMed1990

Masking level difference before and after surgery in unilateral otosclerosis.

The object of this paper was to evaluate the binaural hearing in 20 patients suffering from unilateral otosclerosis. Binaural performance was assessed at a test frequency of 500 Hz using masking level difference (MLD) before and after surgery. The postsurgical results showed abnormal MLDs in patients in whom stapedotomy had successfully corrected the threshold asymmetry. Three possible hypotheses regarding this phenomenon were investigated: (1) cochlear damage, (2) auditory deprivation and (3) a mechanical middle ear anomaly due to the surgical prosthesis or healing processes. The analyses suggest that the conductive hearing loss may effect central auditory processing resulting in poor binaural hearing (auditory deprivation theory).

Adult↗
PubMed1998

[The influence of age and sex on the results of otosclerosis surgery].

The influence of age and sex on auditory improvement after stapes surgery was investigated retrospectively on 127 otosclerotic ears (99 subjects) that were followed up for 6 months postoperatively. The prostheses used were the Shuknecht-type Teflon wire piston (87 ears), the House-type wire loop (29 ears), and the Cawthone-type Teflon piston (11 ears). While closure of the air-bone gap after surgery was good at 2 kHz, it was poor at 8 kHz and frequencies lower than 1 kHz, and especially poor at 250 Hz. At all frequencies, both air and bone thresholds were significantly improved by the surgery, but the greatest improvements in air and bone thresholds resulted from the use of Teflon wire pistons. Ears receiving Teflon wire prostheses were divided into 5 age groups: under 20 years, 20-29, 30-39, 40-49, and 50 or above. Both air and bone thresholds at higher frequencies before surgery worsened with increasing age. However, there were no significant differences among age groups in the postsurgical improvement of either air or bone thresholds. Similarly, no gender-related differences in either air or bone thresholds were recognized postsurgically. The authors speculate that light cases of otosclerosis are common among Japanese patients, while severe cases are rare even among the elderly.

Adult↗
PubMed1990

[HLA and otosclerosis].

The HLA antigens frequencies were studied in 30 Japanese patients with otosclerosis, and were compared with those of 220 randomly-selected apparently healthy unrelated Japanese. Serological HLA typing was performed by the modified two-stage complement-dependent microcytotoxicity method at the Blood Transfusion Service, Tokyo University Hospital. The results were as follows: There was no significant deviation of HLA class I antigen frequencies in the patients tested as compared with those in controls. As for HLA class II antigens, the DRw11 antigens frequency showed slight increase; however, after the correction of the P value, this was not significant.

Adult↗
PubMedDate not supplied

[Historical analysis of otosclerosis surgery].

In the present work main surgical techniques used along the history to solve hypoacusis caused by otosclerosis (opening of the timpani box internal wall, < >, puncture of cephalorachidium liquid, etc.) are studied. Those which have been more spread due to their results are analyzed in more depth (fenestration of the horizontal semicircular ductus, stapes mobilization and stapedectomy).

History, 16th Century↗
PubMed2000

[Surgical treatment of otosclerosis with argon laser].

OBJECTIVES: Argon laser stapedotomy is a new modality for the treatment of otosclerosis. The first results obtained in Denmark are reported. MATERIALS AND METHODS: A retrospective follow-up study was undertaken to evaluate the results of argon laser stapedotomy which was introduced in 1991 at the department of Otolaryngology, Rigshospitalet, Copenhagen. The results are based on 85 consecutive primary stapedotomy operations with argon laser in 76 patients during the period January 1, 1991 to June 30, 1996. Mean follow-up was 16.6 months (6-60). RESULTS: The postoperative air-bone gap was closed within 10 dB or less in 83% of the operations and in 20 dB or less in 98%. The mean speech reception threshold (SRT) was 48 dB preoperatively. All patients had an improved SRT after the operation, with a mean value of 23 dB. At 4000 Hz and 8000 Hz, 89% and 65% of the patients had maintained or improved their hearing. No patient developed profound sensorineural hearing loss or anacusis after the operation. Only one patient developed symptoms of a temporary perilymphatic fistula. CONCLUSION: Argon laser stapedotomy is a safe technique. Its complications are fewer and not as serious as conventional methods. In addition, the achieved hearing results are better, and thus it is a good example of "minimal invasive high success surgery".

Adolescent↗
PubMed2000

Patients' perceived outcomes after stapedectomy for otosclerosis.

We conducted a retrospective study of 29 patients who had undergone stapedectomy for otosclerosis to determine how well their subjective perceptions of hearing improvement correlated with objective audiometric measurements. Patients expressed their assessments of hearing function by completing two versions of the Hearing Disability and Handicap Scale (HDHS). One version of the HDHS was based on patients' retrospective recollections of their hearing impairment prior to surgery, and the other reflected their assessment of their current function. We evaluated these HDHS data both separately and in conjunction with pre- and postoperative audiometric findings. Following surgery, the group's mean pure-tone average improved significantly, from 58 to 27 dB--that is, the average patient had a moderately severe hearing loss preoperatively and only a mild hearing loss postoperatively. Significant improvement was also reflected in the difference between the mean pre- and postoperative HDHS scores, although some patients indicated that they experienced almost no improvement. Overall, our findings indicated that there was a relationship between objective and subjective assessments of hearing improvement following surgery, but that it was weak. Although most patients perceived significant improvement, the degree of that perceived improvement cannot be predicted from the pure-tone audiogram. We conclude, therefore, that a significant difference between audiometric findings and HDHS self-assessments is useful in identifying patients who might benefit from additional counseling and/or aural rehabilitation.

Audiometry, Pure-Tone↗
PubMed2001

[Practical considerations of surgical treatment of otosclerosis].

The ENT-specialist after determine the diagnosis, the deafness degree and the requirements of each otosclerotic individual must consider the therapeutic possibilities and the end results, also the complications, the indications and the contraindications. These considerations are fundamental under the forensic medicine viewpoint and a good medical practice and even in order to avoid failures provided preestablished prospectives and the outcomes fails to adhere to the proposed schedule. Surgical option is promising in cases of severe deafness when our aim is to improve the enlargement and recognition of environmental sounds when an acoustic prosthesis is not employed. In these cases possibly recruitment is present at the initial stages, which requires and adaptation period. Also must be analyzed the influence for surgery of environment factors and life-style (pressure changes, ambient noise, etc.), the existence of tinnitus, equilibrium disorders, hard of hearing features and the age. Results procured with surgery in unilateral otosclerosis are lesser compared with bilateral, which in association with the fact that in the majority od unilateral the degree of impairment (percent of binaural deficit) is minimal, compel us to be very cautions in counseling these patients.

Deafness↗
PubMed2001

[Ambulatory surgery of otosclerosis: retrospective study of 102 cases].

A retrospective study of 102 selected patients operated for otosclerosis (34 outpatient surgery, 68 hospitalised), having all of them the inclusion criteria of the ambulatory surgery, treated as outpatient in a traditional health sector or hospitalised, depending on their own choice, has been lead. We analysed the results of the pure tone audiometric tests two to six months after surgery. No significative difference was found between the two groups on audiometric results as for the postoperative complications. On the other side, it seems that young patients are more interested by the one-day surgery. The failure of the ambulatory surgery could be explained by the vertigo or dizziness per- or postoperatively. Finally, the evaluation of the cost-benefit shows that the ambulatory surgery in a traditional health sector could lead a budgetary saving policy. A saving way that will grow in a specialized sector devoted to the ambulatory practice.

Adult↗
PubMed1999

[The choice of the stapes surgical style in treatments of the otosclerosis].

OBJECTIVE: To investigate the effects of the stapes surgery on treatment of the otosclerosis to find out the more suitable surgical style. METHOD: 71 cases including 31 cases with stapes lifting surgery, 34 cases with partial stapcdectomy, 6 cases with total stapedectomy were summed. RESULT: Both the stapes lifting surgery and partial stapedectomy have steady effects on hearing level for a short or long time. CONCLUSION: The stapes lifting surgery should be adopted as the first surgical style for it is easier and the vestibular reaction is slighter. It will not affect the following surgical process even the two crura are broken.

Adult↗
PubMed2003

[Epidemiological aspects of otosclerosis (II): sex, hereditary factors, its course before diagnosis, age at diagnosis and its beginning].

Retrospective study done with a group of 401 patients enduring otosclerosis. Seventy percent were women. 59% with positive familial antecedents. Illness was recognized as midpoint, at 44.5 years and symptomatology started at 35.3 years. Lasting time of condition till diagnosis assured was 8.5 years (higher than 5 years the half of cases and between 1 an 5 years the third part of them), these numbers considerably decreasing regarding other older series. Figures lower in those cases without familiar otosclerotic antecedents, the same than in unilateral specimen. The only significative influence of sex where tinnitus aurium among women (70.7% to face up 51.7%).

Adolescent↗
PubMed1975

[Otosclerosis like bone in osteogenesis imperfecta tarda].

Bone like in otosclerosis from a 34-years-old man, from 33 years and 22 years old women, suffering from osteogenesis imperfecta tarda, with hardness of hearing in both ears were removed with chisel from the lower border of the oval window. After that a stapedectomy was accomplished. The stapedial crura have been genetically interrupted or broken, the footplate attached to the oval window. The bone from the border of the oval window was prepared for the histological examination. The specimens were coloured with Hematoxylin-Eosin and corresponding to Gomöri. In the bone similar cartilage osteoclasia and osteogenesis are rare. There are in the chondroosseous bone rooms filled with connective tissue. The diseased osseous labyrinth in osteo genesis imperfecta tarda must be regarded as a special morphogenetic formation of osteopsathyrosis.

Adult↗
PubMed2003

[Failure of regain full function after surgery for otosclerosis: causes, diagnosis and treatment].

OBJECTIVE: The aim of this study was to evaluate the causes, the diagnosis, the treatment and the results obtained by revision surgery, in cases of stapedectomy failures. MATERIALS AND METHODS: Retrospective study of 50 recent cases operated on between January 1997 and December 2001. DIAGNOSIS OF THE FAILURE: All reoperated patients had clinical and audiological assessment; CT scan with virtual endoscopy. RESULTS: The mean time of onset of failure was 23 months. The mean preoperative air bone gap was 25.5 dB. Otoscopy revealed a retraction pocket caused by poor eustachian tube function in 9 cases. CT scan proved to be very effective at differentiating the cause of the failure. OPERATIVE FINDINGS: In 11 cases the prosthesis was too short, in 8 cases the prosthesis had migrated out of the hole of stapedotomy and in 6 cases the piston was fixed in the stapedotomy hole. A partial or complete lysis of the long process of the incus was frequently associated, but in 9 cases it was the only cause of the failure. In all the cases when the piston was displaced, the stapedotomy was found to be covered by a thin mucous membrane, avoiding labyrinthine fistula. In 3 cases, the failure was due to recurrent otosclerosis. In 5 cases the failure was due to a local anomaly at the level of the oval window niche, 2 cases of failure were due to a malleus ankylosis. In 5 cases fibrous adhesion was found between the incus and the mucosa of the promontory. In one case a reparative granuloma was found at the level of the oval window. TREATMENT: In cases of partial lysis of the long process of the incus, a new prosthesis was placed in a 0.4 mm diameter stapedotomy, performed using a KTP laser. A 0.4 mm diameter piston was extended 0.2 mm below stapedotomy to avoid a new extrusion. Indeed some prosthesis extrusion could be due to increased movements of the ossicular chain in cases of eustachian tube dysfunction. In cases of complete lysis of the long process of the incus, or in cases of a very short long process of the incus, a piston was put in the stapedotomy and attached to the malleus manubrium. The results of revision stapedotomy were favorable in the absence of associated fibrous tissue adhesion or local malformation. The air bone gap was found to be less than 10 dB in 40 cases and between 10 and 20 dB in 8 cases. An impairment of the air bone gap was found in 2 cases. No case of bone conduction impairment was found in this series.

Adult↗
PubMedDate not supplied

Double-blind study on the effectiveness of a bioflavonoid in the control of tinnitus in otosclerosis.

Ipriflavone (7-isopropoxy-isoflavone) was attempted to relieve tinnitus of otosclerotic patients prior to stapedectomy and continuing the treatment postoperatively in a 6 months regimen. As a whole the double-blind study revealed effectiveness of Ipriflavone in the control of tinnitus when preoperatively administered as well as in combination with stapedectomy. The small number of cases (9 patients treated with Ipriflavone and 7 patients with placebo) needs further confirmation of the present data. Predominantly low-tone tinnitus rises the possibility of its cochlear origin in otosclerosis, as a consequence of mechanical or hydrodynamic causes or hydrostatic pressure elevation due to spread of the otosclerotic focus onto the cochlear duct.

Adult↗
PubMed1992

Evaluation of cochlear function in a patient with "far-advanced" otosclerosis.

A patient with "far-advanced" otosclerosis with a profound bilateral hearing loss was evaluated for cochlear reserve using transtympanic electrocochleography (ECoG) and promontory stimulation. Results indicated that both ECoG and promontory responses were present, indicating that cochlear function was present bilaterally. A stapedectomy resulted in closure of the air-bone gap. Postoperative hearing yielded excellent aided responses compared to no measurable preoperative hearing aid benefit. This case serves to demonstrate the value of evaluating cochlear function using these electrophysiologic techniques.

Aged↗