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At least 595 records · Page 33Linked to original sources
PubMed1978

[The last ear (author's transl)].

An operation of the last ear should not be rejected completely, neither from the clinical nor from the audiological point of view. The special pathology of the ear should be considered critically. Many factors can influence the success of the surgical intervention. An exact and adequate diagnosis taking into consideration all the risk factors has to precede each intervention on the last ear. The personality of the patient and his psychological structure have an important influence on the final decision. The surgeon must be very thorough and careful in explaining the possible consequences of an operation. The intervention should be carried out by an experienced surgeon using a tried and proven method. In the case of operations that are neither threatening the life of the patient nor absolutely necessary from the medical point of view he should stop the intervention when--during the operation--the risk for the remaining hearing capacity results to be too high. In this situation the ear should be dried up and prepared for an hearing-aid. We should ever keep in mind that the hearing-aid even if the communication is not fully-satisfying--is better than an understanding by only lip-reading. The medical principle "nil nocere" is particularly important for the last ear.

Adult↗
PubMed1983

The natural history of otosclerosis. A correlation of the volume and activity of the otosclerotic lesion with age.

Two-hundred and fifty years after Valsalva's discovery that fixation of the stapes could be a cause of deafness, there is still a lack of knowledge about the etiology and pathogenesis of otosclerosis. The purpose of this study was to obtain more information about the natural history of this disease by correlating the volumes and activity of otosclerotic lesions within the temporal bone to the patient's age and sex. Fifty temporal bones from 33 patients (19 females and 14 males) with otosclerotic lesions were reviewed microscopically. The degrees of activity of these foci were assessed and, using a computer based technique known as "digitizing", the volumes of each otosclerotic lesion were calculated. The results of this study indicate that there is no statistical difference in volumes between males and females. From the results obtained, it is suggested that there appear to be two growth patterns of the otosclerotic lesion: one pattern grows for a very short period and then becomes dormant or inactive. The other type of otosclerosis shows a continuing growth and progression throughout life.

Adolescent↗
PubMed1993

[Stapotomy with ultrasound? Animal experiment study of possible side effects].

Stapedectomy by ultrasound has been proposed as an alternative method for perforating the stapes footplate in surgery for otosclerosis. Possible functional adverse effects of ultrasound perforation of the otic capsule in guinea pigs were investigated in the present study by means of vestibular evoked potentials (VsEP). VsEP were elicited by pulsed linear accelerations applied to the animal's head following surgical removal of the middle ear, following intense ultrasound drilling around the otic capsule and after drilling a small hole in the anterior bony wall of the vestibule. All manipulations did not affect amplitudes and latencies of the early potential N1 (less than 1 msec after onset of acceleration). Significant alterations of N1 occurred following direct mechanical damage of the otolithic organs, indicating that VsEP can be used to detect lesions of these receptors and therefore may be used as a parameter of vestibular function in experimental animals. Findings indicate that perforation of the otic capsule by ultrasound is possible without inducing functional lesions of the otolithic organs.

Animals↗
PubMed1995

Surgery in elderly patients with otosclerosis.

Hearing results and complications of surgery were studied in 42 patients with otosclerosis (46 ears operated on) who were over the age of 60 years at the time of stapedectomy. The mean follow-up period was 8 years. The results were compared with those obtained in 275 patients (330 ears operated on) younger than 60 years of age undergoing stapes surgery during the same time period. Large fenestra stapedectomy with fascia seal to the oval window was used in all cases. Hearing results as judged by postoperative air-bone gaps were as good in the older age group as in the younger patients. In contrast to some earlier reports, complications of surgery such as postoperative sensorineural hearing loss occurred not more frequently among elderly patients than in younger patients. It is concluded that stapes surgery should be offered to elderly patients with the same indications as in younger patients with otosclerosis.

Age Factors↗
PubMed1998

A reevaluation of the 512-Hz Rinne tuning fork test as a patient selection criterion for laser stapedotomy.

OBJECTIVE: This study aimed to challenge the classical hypothesis that a negative preoperative 512-Hz Rinne tuning fork test (bone conduction greater than air conduction) is a necessary condition to allow consistent objective and subjective hearing improvement with surgery for otosclerosis. STUDY DESIGN: The study design was retrospective (chart review and questionnaire). SETTING: The study was conducted at a Florida Ear and Sinus Center at Sarasota, Florida, a tertiary otology-neurotology referral center. PATIENTS: Patients who underwent primary laser stapedotomy with equivocal (air=bone) preoperative 512-Hz Rinne test results participated. INTERVENTION: KTP laser stapedotomy was performed. MAIN OUTCOME MEASURES: Audiologic measurements of air-bone gap closure and patient assessment of hearing improvement and satisfaction were conducted. RESULTS: The air-bone gap was closed to within 10 dB in all cases. There were no complications. Eighteen patients were questioned about their results. Hearing improvement was subjectively described as "excellent" or "good" by 17 (94%), and 16 (89%) thought the surgery was "absolutely" worthwhile. CONCLUSIONS: The preoperative 512-Hz Rinne test results need not be negative to achieve significant air-bone gap closure and subjective appreciation of improved hearing.

Audiometry↗
PubMed1998

Laser stapedotomy minus prosthesis (laser STAMP): a minimally invasive procedure.

OBJECTIVE: To determine whether hearing can be restored using a laser without a prosthesis in patients with minimal otosclerosis. STUDY DESIGN: Retrospective case review of 12 patients with minimal otosclerosis who underwent a laser stapedotomy without prosthesis (laser STAMP) procedure. SETTING: An otology/neurotology tertiary referral center. PATIENTS: Patients were chosen for the procedure if there was a blue footplate with minimal otosclerosis confined to the fissula antefenestram. INTERVENTIONS: Using a hand-held probe (CeramOptic), and the HGM argon laser, the anterior crus of the stapes was vaporized. Next, a linear stapedotomy was made across the anterior one third of the footplate. If otosclerosis is confined to the fissula antefenestram, the stapes becomes completely mobile. The stapedotomy opening is sealed with an adipose tissue graft from the ear lobe. MAIN OUTCOME MEASURES: Pure-tone audiometry with appropriate masking and auditory discrimination testing were performed before surgery, 6 weeks after surgery, and 1 year after surgery. RESULTS: The average air-bone gap was closed to a mean (SD) of 2.6 dB (3.3 dB). The average improvement in air-bone gap was 17.4 dB (7.6 dB). The discrimination scores remained unchanged. Audiometric testing of five cases with 1 year follow-up demonstrates that excellent hearing results are maintained. CONCLUSIONS: In selected cases of minimal otosclerosis confined to the fissula antefenestram, normal mobility of the ossicular chain can be obtained without a prosthesis by vaporizing the anterior crus and making a linear stapedotomy across the anterior one third of the footplate. The advantages of the procedure are that the stapedius tendon and most of the normal stapes remain intact, eliminating hyperacusis. The procedure is less invasive so it reduces inner ear trauma, possible prosthesis problems are avoided, and postoperative barotrauma risk is minimized. Minimal surgery is done for minimal disease. If the stapes refixes at some time in the future, a conventional stapedotomy can still be performed.

Adult↗
PubMed1999

[Surgical treatment of acoustically-induced vertigo (Tullio phenomenon)].

BACKGROUND: Tullio phenomenon is defined as noise induced vertigo. Other authors have attributed this symptom to either a perilymphatic fistula or postinflammatory adhesions between the stapes foot plate and the vestibular end organs. METHOD: In this paper two cases are described in which acoustically induced vertigo was explained by abnormal mobility of the stapes. RESULTS: The stapes was stabilized by the placement of cartilage chips beside the crurae of the stapes. Both cases demonstrated long term success, i.e. 4 and 5 years postoperatively.

Adult↗