SEARCH · Search PubMed

Results for “Stapes”

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.

SourceResearch connectionFrom yearThrough year

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

At least 55 records · Page 3Linked to original sources

PubMed1997

Effects of pulsed laser systems on stapes footplate.

BACKGROUND AND OBJECTIVE: The aim of the present study was to investigate the tissue ablation capacity of various pulsed lasers at the stapes footplate. STUDY DESIGN/MATERIALS AND METHODS: Isolated human stapes and bovine compact-bone platelets were used to determine the effective laser parameters and appropriate application technique for achieving a perforation measuring 500-600 microns in diameter. Of interest were also the shape and quality of the perforations, the reproducibility of the perforation effect, and the thermically altered marginal zones occurring at the footplate. Three pulsed laser systems were used: excimer, holmium:YAG (Ho:YAG), and erbium:YSGG (Er:YSGG) lasers. RESULTS: The tissue-ablating effect of pulsed laser systems permits a precise and controlled management of the stapes footplate through low and readily reproducible ablation rates. The extent of thermic side effects at the footplate is lower in comparison to the purely thermically acting cw and superpulse laser systems. The Er:YSGG laser exhibits the highest ablation rate at the stapes and is thus the most effective laser for perforation of the stapes footplate. Though somewhat less effective, the Ho:YAG laser also appears to be suitable for stapedotomy. On the other hand, we do not consider the applied excimer laser (308 nm) to be particularly appropriate at the stapes because of its low ablation rates. CONCLUSION: Thus, the erbium laser could represent an alternative to the argon, KTP 532, and CO2 lasers, already clinically successful in stapes surgery. However, further studies are necessary to examine the transmission of thermic energy into the vestibule and the acoustic stress to the inner ear during laser stapedotomy, to be able to make a definitive statement about the safest and most effective laser system for stapes surgery.

Animals↗

PubMed2002

[Diagnosis and therapy of stapes fractures and luxations].

BACKGROUND: Injuries of the ossicular chain have various etiologies. Skull traumas from blows to the temporal, parietal or occipital region with or without fracture of the temporal bone are the main causes of the ossicular injury; other modes of injury are rare. It depends on the type of trauma which kind of injury occurs. Mainly subluxations, luxations and fractures are to be observed. The incus is the ossicle which is the most often injured. Mostly, only one ossicle is injured, rarely two or all of them. PATIENTS: From January 1997 to June 1999 we operated 19 patients with traumatic lesions of the membrane and the middle ear. In 4 cases the reason for the operation was an injury of the stapes. We observed 2 cases with broken stapes crura, 1 case with an impression of the stapes into the vestibulum with perilymphatic fistula and 1 case with subluxation of the stapes in the direction of the promontorium. By presenting 4 cases we want to point out the diagnostic possibilities and the operative management of such rare injuries. In all cases we applied the transmeatal approach for the operation of the middle ear. In 2 cases it was possible to place the stapes back in their anatomic position in order to re-establish the ossicular chain. In the other 2 cases we had to use middle ear prostheses which were interpositioned between the manubrium of the malleus and the footplate of the stapes. RESULTS: In all cases the immediate post-operative hearing results and the long-term hearing results after 10 to 28 months were satisfying. We did not notice any post-operative complications, especially no vestibular symptoms. One patient's tinnitus was the same as before the operation. CONCLUSIONS: The diagnosis of a stapes injury is despite the use of sophisticated technology, especially the CT-scan of the temporal bone, often very difficult. A sensitive anamnesis seems to be very important. It depends on the kind of injury which operative technique is to be applied in order to re-establish the ossicular chain. In our opinion, it is useful to take - if it is possible - the autolog stapes for the surgical re-establishment of transmission.

Adult↗

PubMed1977

Postinflammatory osteogenic fixation of the stapes.

Stapes fixation existing with chronic otitis media has been attributed usually to either tympanosclerosis or concomitant otosclerosis. A different type of stapes fixation has been encountered which the author has termed "post-inflammatory osteogenic stapes fixation." One thousand five hundred and two surgical procedures for chronic otitis media were reviewed with 112 rigid stapes fixations found of which 19 were classified as post-inflammatory osteogenic stapes fixation. Surgical techniques were discussed, case histories were presented, and photomicrographs were shown illustrating two varieties of post-inflammatory osteogenic stapes fixations classified according to the side of the fixing lesion. The etiology and pathogenesis of this condition were felt to have a direct relationship to infection and prior surgery. Post-inflammatory osteogenic stapes fixation probably occurs more frequently than realized. Further research is needed to evaluate this type of stapes fixation.

Adolescent↗

PubMed2005

Two subgroups of stapes fixation: otosclerosis and pseudo-otosclerosis.

HYPOTHESIS: Stapes ankylosis is a disease with variable histopathology and can be caused by otosclerosis or pseudo-otosclerosis. Viral pathogenesis of otosclerosis could be established only by correlative analysis: histologic examination of the stapes footplate and reverse-transcriptase polymerase chain reaction (RT-PCR) amplification of the viral RNA. BACKGROUND: Presence of the RNA genome of measles virus was demonstrated in the footplates of clinically otosclerotic patients by RT-PCR, and also viral proteins were detected by immunohistochemistry. METHODS: Nucleic acids were extracted from ankylotic stapes footplates of clinically stapes fixation patients (n = 104). Measles virus genomic nucleoprotein (NP) RNA was amplified by seminested RT-PCR. Amplification results were correlated to postoperative histologic and audiologic findings. RESULTS: Measles virus RNA was detectable only in histologically otosclerotic stapes footplates (n = 67). Histology for virus negative footplates (n = 37) excluded otosclerosis. Virus negative stapes footplates showed nonotosclerotic, degenerative disorders. CONCLUSIONS: Stapes ankylosis is a heterogeneous disease causing conductive hearing loss with different etiologies. Nonotosclerotic stapes fixations could be established as pseudo-otosclerosis and may belong to nonspecific, degenerative disorders with variable and noncharacteristic histopathology. Otosclerosis is an inflammatory disease caused by persisting measles virus infection of the otic capsule.

Adult↗

PubMed2001

[An experimental study for qualitatively diagnosing stapes lesions by helical 3-dimensional CT].

To evaluate qualitative diagnosis of stapes lesions by 3-dimensional computed tomography (3D-CT) combined with superselective image processing (3D-SS) of stapes, we studied helical 3D-CT on a phantom model of the temporal bone. Two stapes models were used-1 made from the bone filler, Celatite, consistent in bone density but changing in cross sectional area, and the other made from an apacerum rod used in quantitative computed tomography (QCT), consistent in cross sectional area but changing in bone density. These stapes models were put into a skull phantom and analyzed by helical 3D-CT. The influence of the tympanic cavity conditions on CT images of stapes was evaluated by filling the phantom model with Vaseline following 3D selective reconstruction. In all stapes models, lowering the lower CT window width threshold resulted in an enlarged cross-sectional area of the model. The higher the bone density, the lower the increase in cross-sectional area in the image. The stapes model with lower density had greater influence on the imaging by tympanic cavity conditions and was likely to be misdiagnosed as showing higher bone density. Based on the experimental study, 3D-SS by helical 3D-CT appears to be a useful measure for qualitatively diagnosing stapes lesions.

Hearing Loss, Conductive↗

PubMed2003

Revision stapes surgery: the malleus to oval window wire-piston technique.

OBJECTIVE: To determine the effectiveness of the malleus to oval window wire-piston revision stapes surgery technique. STUDY DESIGN: A retrospective analysis of 243 stapes procedures performed by the senior author over a 10-year period identified 15 revisions. Five patients underwent a malleus to oval window wire-piston technique. All patients were followed for at least 6 months. The surgical outcome including audiologic data and complications are noted. METHODS: Stapes surgery was performed on an ambulatory basis by way of a transcanal approach under local anesthesia with monitored sedation by the same surgeon using a laser technique and a stapes wire-piston prosthesis. RESULTS: Among revision stapes procedures, there was no significant difference in the air-bone gap closure or complication rate between the incus to oval window and the malleus to oval window techniques. The average preoperative air-bone gap in all revisions was 32 dB, whereas the mean postoperative gap was 10 dB hearing loss. CONCLUSIONS: In experienced hands, revision stapes surgery using the malleus to oval window stapes wire-piston prosthesis is safe and effective.

Adult↗

PubMed2005

First experience with a new stapes clip piston in stapedotomy.

OBJECTIVE: Hearing results after 23 implantations of a newly designed titanium-clip stapes piston prosthesis (the àWengen Clip Piston prosthesis) in patients with otosclerosis were evaluated. This new type of stapes piston was designed to avoid the crimping onto the incus in stapedotomy. This one clip fits all designs and enables solid fixation by clicking the prosthesis onto the long process of the incus without crimping. STUDY DESIGN: A retrospective pilot study was carried out by microcomputer of the preoperative and postoperative audiological results of patients in whom the titanium-clip stapes piston prosthesis was implanted. SETTING: Ear, nose and throat department of Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. PATIENTS: 23 Patients underwent a stapedotomy for hearing improvement suffering from otosclerosis. implantations of a newly designed titanium-clip stapes piston prosthesis (the àWengen Clip Piston prosthesis) in patients with otosclerosis were evaluated. INTERVENTION(S): The stapedotomy was performed with the àWengen Clip Piston prosthesis. MAIN OUTCOME MEASURE(S): Pre and postoperative audiograms were used to evaluate the hearing gain improvement with the new stapes piston. Especially we looked at the airbone gap closure and the sensorineural hearing after the surgical procedure and compared these with the ones before surgery. RESULTS: The hearing results showed a closure of the pure-tone average air-bone gap to within 10 dB in 56.6% of cases (10 of 23 implantations) and to within 20 dB in 100% (23 of 23 implantations). A residual air-bone gap of greater than 20 dB was seen in the present pilot study. Postoperative overclosure of bone-conduction thresholds was discovered only for the frequency of 2 kHz. Sensorineural hearing loss greater than 10% did not occur, and there was no decline in the speech discrimination. CONCLUSIONS: The use of a newly designed titanium-clip stapes piston prosthesis with a diameter of 0.4 mm gives good results in cases of stapedotomy for otosclerosis. The titanium-clip design is a new development in the evolution of stapes piston prostheses. Surgical introduction, placement, and fixation are not always easy, depending on the anatomy of the middle ear and the thickness of the fixation area on the long process of the incus.

Audiometry↗

PubMedDate not supplied

Three-dimensional stapes footplate motion in human temporal bones.

The literature provides conflicting information on whether the motion of the stapes footplate is piston-like or some other type of motion, such as rotational or rocking. Examination of the three-dimensional (3D) motion of the stapes footplate appears to be an excellent way to understand this complicated motion. Five microsphere reflective targets were placed on the stapes footplate in ten fresh human cadaver temporal bone preparations, and their vibration measured through an extended facial recess approach using a laser Doppler vibrometer. The five target sites on the stapes footplate were center, anterior, posterior, superior and inferior. The stimulus was a sound input of 80-120 dB SPL at the tympanic membrane over a frequency range of 0.1 to 10 kHz. The 3D motion of the stapes footplate was calculated using the velocity amplitude and phase obtained for each target. For frequencies up to 1.0 kHz the vibration of the stapes footplate was primarily piston-like; this motion became complex at higher frequencies, with rotary motion along both the long and short axis of the footplate. When the cochlea was drained, stapes footplate motion became essentially piston-like for all frequencies.

Aged↗

PubMed1995

Measurements of the stapes superstructure.

Ten human stapes from fresh temporal bones were measured to obtain relevant distances of the stapes superstructure. The dimensions of the parts of the superstructure are as follows: 1) stapes head 1.14 mm (range, 0.91 to 1.49) in diameter parallel to the axis of the footplate and 0.83 mm (range, 0.65 to 1.08) perpendicular to it; 2) stapes head to shoulders 0.93 mm (range, 0.81 to 1.07), head to foramen 1.26 mm (range, 1.15 to 1.39), and head to lateral surface of stapes footplate 3.19 mm (range, 2.91 to 3.45); 3) neck width parallel to the axis of the footplate 1.18 mm (range, 0.88 to 1.47) and 0.64 mm (range, 0.48 to 0.88) perpendicular to it; 4) anterior crus 0.58 mm wide (range, 0.41 to 0.74) at the shoulder of the arch and 0.51 mm (range, 0.39 to 0.65) closer to the stapes footplate; 5) posterior crus 0.65 mm wide (range, 0.46 to 0.77) at the shoulder of the arch and 0.55 mm (range, 0.38 to 0.75) closer to the stapes footplate; and 6) maximum width of entire superstructure near footplate 2.48 mm (range, 2.06 to 2.98).

Age Factors↗

PubMed1989

[Superstructure of stapes: an analysis by high-resolution computed tomography].

High-resolution Computed Tomography (HRCT) of the temporal bone has now become a routine test for the diagnosis of various temporal bone lesions. Correct assessment of such minute structures as ossicles, especially stapes, is important in the pre-operative HRCT evaluation. On the other hand, analysis for the reliability of HRCT findings has not been done, including the superstructure of the stapes. A retrospectively study was done in order to assess the availability of HRCT findings in axial overlapping scans in 226 ears, with respect to the superstructures of stapes. The study was concerned with the analysis of HRCTs of 148 normal ears, 71 ears of chronic otitis media and 7 ears of ossicular abnormalities. HRCT findings were compared to those of surgeries in pathological cases. The present study revealed that the superstructures of stapes are noted in 70% when the stapes surrounded by air. The major limitations in the proper analysis of stapes by HRCT are partial volume averaging and effects of soft tissue silhouetting, this is especially so when the stapes is surrounded by soft tissue density.

Chronic Disease↗

PubMed2004

[Stapes fixation in children].

BACKGROUND AND OBJECTIVE: The audiometric results after stapes surgery in children with isolated stapes footplate fixation were reason enough to analyze intraoperative findings and surgical procedures. PATIENTS/METHODS: A total of 438 stapes surgeries were performed in the years 1985-2000, and a retrospective analysis was made of the anamnestic data, intraoperative findings and audiometric data from 12 children with isolated fixation of the stapes footplate. The average age of the children when operated was 10.2 years (the youngest was 7 and the eldest 13). A loss of hearing had set in 5 years earlier. RESULTS: Taking the anamnestic data and the intraoperative into account, otosclerosis was found in 5 children. One child had a narrow oval window niche, in a further six children a congenital fixation of the stapes footplate was evident. Only 58% (n=7) of the 12 children operated showed acceptable postoperative hearing results. The best hearing results were found in children with juvenile otosclerosis. In three of six children with congenital stapes fixation, a worsening of both bone and air conduction was evident. The average conductive hearing loss was 30 dB at 1, 2 and 4 kHz. CONCLUSIONS: When explorative tympanotomy is indicated, a thin-layer CT scan of the temporal bone should be made to assess the risk of a liquor pressure labyrinth developing.

Adolescent↗

PubMed2006

[Traumatic luxation of the stapes: radiology and surgical outcome].

OBJECTIVES: To describe the value of high resolution computed tomography scan (HRCT scan) in post traumatic hearing loss. METHOD: HRCT scan of the temporal bone in millimetric cut with axial and coronal views was performed. RESULTS: CT scan confirmed pneumolabyrinth with intact stapes depressed deeply into the vestibule. Surgical exploration was performed and the stapes was gently removed from the vestibule. CONCLUSION: CT scan confirmed the diagnosis and studied the stapes integrity. Hearing deteriorated postoperatively is increased in case of stapes fracture. When a luxation of the stapes into the vestibule is suspected, it is important to determine how deeply and whether it is fractured. When such a case is encountered, high resolution CT scan of the temporal bone must be performed to confirm the diagnosis and to confirm integrity of the stapes.

Audiometry↗

PubMed2001

Comparative electron microscopic study of the surface structure of gold, Teflon, and titanium stapes prostheses.

HYPOTHESIS: The goal of this study was to compare stapes prostheses of different materials with respect to their surface structures and to discuss their suitability for their use in stapes surgery. BACKGROUND: The surface condition of a stapes prosthesis plays an important role in relation to the type of membrane that forms between the stapes piston and the bony edge of the stapedotomy opening. The quality of this membrane in thickness and mobility is one of the determinants for postoperative hearing improvement. METHODS: The surface conditions of gold, Teflon/steel, Teflon/platinum, and titanium stapes prostheses were examined with a scanning electron microscope. The loop, shaft, and end of each prosthesis were studied. RESULTS: The gold piston was the smoothest of the four pistons examined. When it was cut with a scalpel, a very smooth surface was achieved at the end area. The Teflon piston had the roughest surface. However, when it was cut, a smooth surface with a parallel arrangement of fibers resulted. Its steel loop was the smoothest, followed by gold and platinum. The titanium shaft had a scaly surface, which remained when the end of the shaft was shortened. CONCLUSION: Because a certain roughness of the piston surface is necessary for the development of a stable membrane between the piston and the edge of the stapedotomy opening, the titanium prosthesis is considered to be the most suitable for stapes surgery of the three pistons examined.

Gold↗

PubMed1987

Stapes vibration produced by the output transducer of an implantable hearing aid. Experimental study.

The function of the output transducer of an implantable hearing aid was assessed by applying it to the stapes head in seven fresh human cadaver temporal bones while observing vibration of the stapes under a microscope with the use of a stroboscope and a video measuring system. The transducer was a 5 X 1.2 X 0.6-mm piezoelectric ceramic bimorph with attached metal holder. Transmission changed with the amount of force holding the transducer tip on the head of the stapes. An optimal connection between the vibrator and stapes produced better transmission than a tight or loose connection. Gluing the connection with cyanoacrylate cement decreased transmission in the optimal connection, produced no change in the tight connection, and improved transmission in the loose connection. Comparison of stapes displacement produced by the vibrator at 1 kHz with that produced by normal middle-ear sound transmission revealed that the vibrator-induced stapes displacement for a 1 V peak-to-peak input was equivalent to that produced by a sound stimulus of 90-dB sound pressure level at the tympanic membrane.

Ear Ossicles↗

PubMed2003

Descriptive growth model of the height of stapes in the fetus: a histopathological study of the temporal bone.

Temporal bone histological findings can be evaluated from several points of view. The most basic consists of a description of the characteristics and abnormalities of particular temporal bones. The second one is the measurement of various structures in a larger set of temporal bones and the monitoring of these structures over time. The height of stapes was measured in a set of 40 temporal bones from 27 fetuses, and the growth of stapes from the 13th to 36th weeks of pregnancy was determined. A computer-assisted nonlinear regression analysis of diagnostics enabling simultaneous examination of data (influential points, i.e., outliers and leverages) was carried out, a growth curve model proposed and a mathematical method with Ratkowski criteria for estimation applied to find the best descriptive model of the height of stapes versus time y= f(x) growth curve; the results of 13 growth models were examined. It was found that the maximum growth of the height of stapes was between the 13th and the 24th weeks of pregnancy. The average height of stapes was 1.05 mm in the 13th week and 2.6 mm in the 24th week. Later, after the 25th week, the growth of the height of stapes was slower, and the average height in the 30th week was 3.0 mm.

Fetus↗

PubMed2001

Measurement of stapes mobility in guinea pigs and rabbits.

In tympanoplasty, it is essential to know the condition of the stapes. However, it has been difficult to evaluate stapes mobility in routine measurement. With the eye on improving future clinical practice, in this study we developed a new, easy system of measuring stapes mobility quantitatively and, as a first step, applied it to measurement of the relationship between the load and displacement of the stapes in guinea pigs and rabbits. The stapes displacement increased linearly with an increase in load in the small displacement region, and increased nonlinearly in the large displacement region. The slope of the regression line of this stiffness curve in the small displacement region was used as an index of the stapes mobility. The values in the guinea pigs and rabbits were 16+/-7 N/m and 115+/-25 N/m, respectively. A significant difference between the two species was observed.

Animals↗

PubMed1989

Discovery of the earliest-known tetrapod stapes.

The evolution of the middle ear is central to the discussion of how the first tetrapods adapted to life on land as well as their phylogeny. Here I report the discovery of the stapes of Acanthostega gunnari, from the Upper Devonian of east Greenland. This is the earliest tetrapod stapes so far described, and it throws new light on both these aspects of early tetrapod biology. It has been assumed that the common inheritance of all early tetrapods was a light, rod-like stapes associated with a temporal notch in the otic region that was thought to have supported a tympanum, or eardrum. The stapes would have conducted vibrations from the tympanum to the otic capsule. By contrast, the stapes of Acanthostega was stout with a broad distal ramus associated with the temporal notch. I suggest that the temporal notch of Acanthostega and other early tetrapods supported a spiracular opening rather than a tympanum, and that the stapes controlled palatal and spiracular movements in ventilation.

Adaptation, Physiological↗

PubMed2005

How we do it: ionomeric cement to attach the stapes prosthesis to the long process of the incus.

Keypoints * The successful use of glass-ionomeric cement in primary stapes surgery for attachment of the wire loop of the stapes prosthesis to the long process of the incus is reported. * Early hearing outcomes were similar in patients where cement was used for stapes prosthesis attachment compared with those with standard wire crimping technique. * Use of glass-ionomeric cement to attach the stapes prosthesis to the incus may prevent stapes prosthesis displacement and loosening. * This technique may decrease rates of revision stapes surgery and allow the safe use of magnetic resonance image scanning.

Female↗