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At least 631 records · Page 35Linked to original sources
PubMed2003

Stapes surgery in relation to age.

This prospective study aims to evaluate the efficacy of stapedotomy in relation to age. Eighty-four ears of 82 consecutive patients who underwent stapedotomy were studied. Patients were divided into five groups according to their age. In each patient, we evaluated the pre- and postoperative auditory thresholds, according to the Committee on Hearing and Equilibrium of the American Academy of Otolaryngology - Head and Neck Surgery guidelines. Statistically significant (P < 0.05) differences between the pre- and postoperative air conduction thresholds were observed in all groups. Statistically significant reductions of air-bone gap were observed at lower-medium frequencies (250, 500 and 1000 Hz) in the elderly as well as in the younger patients. We did not find a higher susceptibility of the inner ear to surgical trauma in the elderly in comparison to the younger patients. Our data show that stapedotomy results in older adults are comparable to those obtained in the younger, without an increased incidence of complications.

Adult↗
PubMed1994

[Long-term results of stapes surgery with the Schuknecht wire-teflon prosthesis].

Early and late postoperative findings in 78 cases of stapedial surgery with 0.6 mm Schuknecht Teflon Wire Pistons only, performed from 1983 to 1987, were analysed to evaluate the supposition of an inverse relationship of the size of the footplate fenestration and functional long-term results. In respect of the size of fenestration our surgical strategy resulted in 3 different situations: stapedotomy (26)--partial platinectomy (34)--stapedectomy (19). Mean air conduction thresholds for frequencies 0.5-4 kHz were evaluated preoperatively, one month and > 5 years postoperatively. The results were postoperatively significantly better in all 3 groups without significant intergroup differences. > 5 years postoperatively the best results were seen in the partial platinectomy group better than after stapedotomy and significantly better than in the stapedectomy group. With regard to overclosure, closure of the air bone gap and deterioration of bone conduction thresholds at 4 kHz for the same groups, no significant differences were noticed. In conclusion, the best long-term results were obtained after partial platinectomy, i.e. there was no inverse relation of the size of the footplate perforation and the best results. The perforation should be large enough to prevent tilting of the piston at the edge. Removal of larger parts should be omitted. In case of early mobilisation and stapedectomy good long-term results can still be expected.

Auditory Threshold↗
PubMed1995

[Diagnosis in persistent vertigo after stapes surgery].

One hundred sixty-two otosclerotic patients who underwent a stapedotomy between October 1991 and April 1994 were examined after experiencing postoperative vertigo. Twenty-eight complained of dizziness. In sixteen patients, we observed vertigo and nystagmus only within the first six postoperative days; in these cases, special treatment was not necessary. However, in twelve patients in whom vertigo persisted even after their stay in the hospital, the problem seriously affected their quality of life and their return to work. In these cases, an individualized diagnostic and therapeutic procedure was indicated. Case reports demonstrate the usefulness of several diagnostic methods (analysis of the case history, audiogram, investigation of the vestibular system, and elimination of non-vestibular causes of vertigo. But only high-resolution computed tomography scans of the temporal bone showed definite results. Air bubbles at the end of the prosthesis as indirect sign of perilymphatic fistula, bad position of the piston, new centers of otosclerosis, cicatrices, and in one case fracture of the prosthesis. Ten of the twelve patients required revision surgery. In most patients with persisting vertigo following stapedotomy, revision surgery was justified. However, high-resolution computed tomography is recommended.

Adult↗
PubMed2003

A method to intraoperatively assess stapes prostheses for magnetic attraction.

OBJECTIVE: To present a technique used to assess metallic otologic prostheses for magnetic susceptibility during surgery. STUDY DESIGN: Description of a surgical technique. METHODS: A sterile handheld pacemaker magnet is used to evaluate the prosthesis prior to implantation. The magnet is placed over the prosthesis and the prosthesis is placed directly on the magnet. Any evidence of magnetic attraction and the prosthesis is rejected prior to implantation. RESULTS: None of the prostheses screened showed any magnetic attraction. As a control, steel wire was cut into pieces with dimensions similar to prostheses. These sections of wire were readily attracted to the magnet. CONCLUSIONS: Intraoperative screening of metallic prostheses for magnetic susceptibility is possible using a sterile handheld pacemaker magnet.

Intraoperative Period↗
PubMed1997

The autosomal dominant syndrome with congenital stapes ankylosis, broad thumbs and hyperopia.

A family is reported with conductive hearing loss, hyperopia, broad thumbs and broad first toes. The family resembles a previous reported family (Teunissen B, Cremers CWRJ (1990) Laryngoscope 100: 380-384) but additionally all affected members have a typical face. Overlap of the Teunissen and Cremers syndrome with the facio-audio-symphalangism syndrome and proximal symphalangism is discussed.

Abnormalities, Multiple↗
PubMed2002

Safety of the erbium:yttrium-aluminum-garnet laser in stapes surgery in otosclerosis.

OBJECTIVE: The purpose of this study was to present early and late bone-conduction hearing thresholds and data about cochlear and vestibular disturbances in patients after erbium:yttrium-aluminum-garnet (Er:YAG) laser stapedotomy in otosclerosis. STUDY DESIGN: The study design was a retrospective study. SETTING: The study was conducted at an academic tertiary referral center. PATIENTS: In this study, audiologic data of 117 patients undergoing Er:YAG laser-assisted stapedotomy for otosclerosis between 1993 and 1999 were included. MAIN OUTCOME MEASURES: The preoperative minus 2 postoperative (early, 1-3 days; late, at least 6 weeks) average pure-tone bone-conduction thresholds at 1, 2, and 4 kHz and 0.5, 1, 2, and 3 kHz were calculated. The postoperative appearance of nystagmus, vertigo, and tinnitus was analyzed. RESULTS: A total of 91 of 117 patients showed unchanged preoperative minus postoperative pure-tone bone-conduction averages at 1, 2, and 4 kHz in the late postoperative measurement. A slight deterioration was observed in 8 of 117 patients. Regarding the frequencies 0.5, 1, 2, and 3 kHz, 97 of 117 patients showed unchanged preoperative minus postoperative pure-tone bone-conduction averages. A new transient tinnitus appeared in 37 of 117 patients, and a new persistent tinnitus was found in 3 of 117 patients. Most of the patients had no postoperative dizziness (63/117 patients) and no postoperative nystagmus (109/117 patients). CONCLUSION: The study did not show significant sensorineural hearing loss at or below 3 kHz. Vestibular and cochlear function has no clinically relevant suppression after Er:YAG laser stapedotomy.

Adolescent↗
PubMed2004

Stapes surgery in the United States.

OBJECTIVE: A contemporary analysis of trends in the surgical management of otosclerosis in the United States is presented. DATA SOURCES: U.S. population demographics were obtained from the U.S. Census Bureau. Surgical case data was obtained from publications of the National Center for Health Statistics. Physician population statistics are published by the American Medical Association. DATA EXTRACTION: Available estimates for otologic operations are interpreted according to clinical setting used for data acquisition and surgical practice patterns. Linear regression of included data defines trends in operations performed. Population statistics are used to define changes in the incidence of surgical cases. CONCLUSIONS: The number of stapedectomy cases has declined over the past 30 years. During this same interval, the U.S. population (including the white population) and the number of surgeons has increased. This indicates that the incidence of surgical otosclerosis is declining. Although the true etiology of the decline is uncertain, widespread immunization for measles is a plausible hypothesis.

Adolescent↗