[Complications in the surgical treatment of otosclerosis].
Explore the source record for details and available documents.
SEARCH · Search PubMed
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.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The review concerns application of impulse Nd-YAG laser (wave length 1.32 micron) in stapedial operations. Laser beam provides more accurate and less traumatic conduction of complex stages of stapedoplasty: dissection of the limbs of the stapes with preservation of the stapedial muscle, arrest of bleeding from the vestibule mucosal vessels, thinning of the base of the stapes. However, perforation of the base of the stapes by impulse Nd-YAG laser is not safe because of the treat of radiation and mechanical damage to essential structures of the internal ear.
A retrospective study was made of 183 stapedectomies performed at the Santiago de Compostela Hospital from 1989 to 1996. Sixty-seven percent (67.3%) of patients were women and 32.7% were men. Good results were obtained in 87% of cases (79% had an air-bone gap closure difference under 10 dB, and 8% 10-20 dB). Ten pefect had not change in air threshold and the rest deteriorated. There were no significant differences between stapedectomy and stapedotomy. The 4. 000-Hz improvement obtained was inferior to those in 500, 1,000 and 2,000 Hz. In 8.7% of patients with obliterated footplate, heaving outcome was significantly worse. In patients with exposed or overhanging facial nerve, floating footplate, middle ear fibrosis, and necrosis of the long incus process had better results. Total sensorineural hearing loss occurred in 1.1% of cases.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVES: The aim of this study was to identify causes of primary stapedectomy failures and to evaluate hearing results in revision stapes surgery. MATERIAL AND METHODS: We retrospectively reviewed a series of 26 revision stapedectomies. Patient characteristics, preoperative findings, causes of failure and complication of primary stapedectomy and postoperative hearing results were noted. RESULTS: Conductive hearing loss was the most common reason for revision surgery (77 %). Leading causes of stapedectomy failure included prosthesis malfunction (42 %), fibrous adhesions (37,5 %), incus erosion (12,5 %) and otosclerotic regrowth (12,5 %). When revision was indicated because of cochleo-vestibular complication, middle ear exploration revealed 3 problems: oval window granuloma or excessively long prosthesis or perilymphatic fistula. In this series, postoperative air-bone gap was closed to less than 10 dB in 57 % of cases, to less than 20 dB in 71 % of cases and we did not observed any sensorineural hearing loss. CONCLUSION: The results of this series are comparable with previously published studies. Revision stapes surgery is not as successful as primary stapedectomy, but the risk of sensorineural hearing loss does not appear to be higher than in primary surgery. Revision surgery is a challenging problem that must be performed by an experienced surgeon.
Explore the source record for details and available documents.
Management of 10 cases of primary perilymph fistula is described. The modified technique of stapedectomy described in this article, seems to prevent primary perilymph fistula; time will tell if it will prevent secondary fistula. The hearing gain obtained with this technique is slightly inferior to the gain obtained with Gelfoam-wire prosthesis, but most significant is the fact that discrimination score is excellent in all cases. The author is convinced that the extra time and dexterity required to perform this procedure are well justified by the safety provided and the results obtained.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We performed a retrospective chart study (including surgeon's notes and audiometric results) and an analysis of the archival temporal bones from a patient who had undergone surgery for stapes mobilization in both ears. The stapes footplate was submerged into the vestibule on the right (as a complication of surgery) and absent on the left. One interesting finding was that the patient's hearing had improved on the right despite the presence of the depressed footplate and that the air-bone gap had widened on the left despite the absence of complications on that side.