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At least 955 records · Page 53Linked to original sources
PubMed1990

Stapedectomy in residency--the UAB experience.

A retrospective study of the resident-performed stapedectomies at the University of Alabama-Birmingham over the last 10 years was done. "Satisfactory" results, depending on the audiologic criteria used, were obtained in 60-64 percent of cases, far below the 90-95% success rate of established otologic surgeons. The reason for the low success rate is extremely limited experience, an average of 0.78 cases per residency at this institution. Other training programs have reported slightly higher success rates, all in the 60-80 percent range, but each had a higher average number of stapedectomies per resident. Some comments and suggestions are offered on the continuing controversy of stapedectomy in residency.

Adult↗
PubMed1993

Current practice of stapedectomy in Great Britain.

Since the introduction of stapedectomy with reconstruction of the ossicular chain to Great Britain, many modifications in practice have taken place. The changes include patient selection, operative technique and the type of prosthesis used, as well as the number of operations performed yearly. The aim of this study is to attempt to establish the actual practice among British otolaryngology consultants by means of a simple questionnaire. Two hundred (50.3%) forms were analysed anonymously. The study confirms the decrease in the number of operations performed annually, the absence of centralization for this type of surgery in Great Britain and also demonstrated the trends towards stapedotomy and the practice of bilateral surgery amongst younger consultants.

Humans↗
PubMed1978

Surgical treatment of tympanosclerosis.

During the 5-year period (1971--1976), 45 patients at the Shea Clinic underwent reconstructive surgery for tympanosclerosis. The most common ossicular chain problem was found to be malleus and incus fixation (33%); malleus, incus, and stapes fixation (22%); and stapes fixation (13%). The most successful reconstrucitve approaches included removal of tympanosclerosis from tympanic membrane or isolated plaque from ossicular chain, the use of the Partial Ossicular Replacement Prosthesis (PORP), and the Total Ossicular Replacement Prosthesis (TORP).

Ear Ossicles↗
PubMed1993

Carbon dioxide lasers for otosclerosis.

Over the past eight years, the senior author (SGL) has sought the ideal microsurgical laser for otosclerosis surgery. This quest required learning the principles of laser physics and of the interactions of light with matter. Rather simple thermocouple experiments were performed in the laboratories of the Midwest Ear Foundation (MEF) to confirm some of what was predicted from these principles. More sophisticated transmission spectroscopy experiments were performed at the Massachusetts Institute of Technology (MIT) to evaluate which electromagnetic wavelengths are best absorbed by collagen and bone. MIT's spectroscopy studies paralleled MEF's thermocouple data. CO2 laser energy (10.6 microns) is nearly completely absorbed by collagen and bone, whereas visible argon and KTP laser energy (0.5 micron) is poorly absorbed. Despite the better optical precision of visible lasers, the author chose the CO2 laser for stapedectomy revision and stapedotomy, because long infrared electromagnetic energy has vastly superior tissue absorption characteristics for these procedures. With the development of I. L. Med's Unilase, the otologic surgeon now has a CO2 laser with optical precision and convenience approaching that of visible lasers. Clinical studies of 102 consecutive CO2 laser stapedectomy revisions show that in 92% of patients, hearing was significantly improved with the new CO2 laser revision techniques. Nearly half of these patients had undergone one or more previous, unsuccessful, nonlaser revisions. For primary otosclerosis, CO2 laser stapedotomy has simplified a technically difficult operation while significantly reducing mechanical trauma to the inner ear. Most gratifying to the senior author is that after approximately 450 consecutive CO2 laser operations for otosclerosis, no patient has experienced significant postoperative sensorineural hearing loss (greater than 15 dB; mean 500, 1000, 2000, 3000 Hz). This fact alone has justified our theoretical and laboratory efforts to find the safest laser for otosclerosis surgery.

Carbon Dioxide↗