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At least 1,045 records · Page 58Linked to original sources
PubMed2003

Myringostapediopexy: surgical expectation.

Myringostapediopexy may occur as a result of incus erosion with medialization of the tympanic membrane and is recognized as often producing serviceable hearing. The technique may be used as part of tympanoplasty following either canal wall up or canal wall down surgery for chronic otitis media. The use of this type of reconstruction is influenced by the anatomy of the ear after disease excision. This review of the hearing levels associated with myringostapediopexy shows that there is a similar range of hearing level both for naturally formed as well as surgically fashioned myringostapediopexy. For both 'naturally formed' and following canal wall up surgery about 80 per cent of patients will have an air-bone gap of 20 dB or less compared to 60 per cent of those who undergo canal wall down surgery.

Adolescent↗
PubMed1990

[Degree of middle ear malformation in developmental defects of the I and II branchial arches].

The authors describe various grades of middle ear malformations in 22 patients with developmental defects of the first and the second branchial arch. Middle ear malformations were divided into three groups, according to Altmann's classification, on the basis of physical examination, X-ray investigations and surgeon's opinion. The analysis of the material helps in the assessment of possible anatomical and physiological benefits of surgery in each group of malformations.

Abnormalities, Multiple↗
PubMed1989

[Current trends in stapedial surgery].

The authors discussed their experiences of otospongiosis++ surgery in 949 patients as regards to technical differences, final results and complications. The review of literature was also described.

Humans↗
PubMed1980

Hearing patterns in dominant osteogenesis imperfecta.

Audiologic evaluations and impedance audiometry were obtained on persons from 13 families with dominant osteogenesis imperfecta (OI). Hearing impairment appeared in the late second or early third decade, usually with a conductive loss. Older patients had mixed or sensorineural losses. There was an increasing risk for hearing loss with advancing age. Impedance tests suggested that ossicular fixation may be the primary cause of middle ear disorders in patients with mixed or conductive hearing losses. The cause of sensorineural hearing loss could not be determined. The long-term success of otologic surgery in OI is uncertain. Amplification may be a reasonable alterative to surgery.

Acoustic Impedance Tests↗
PubMed2004

[Bone ablation using ultrashort laser pulses. A new technique for middle ear surgery].

OBJECTIVES: Laser applications within the tympanic cavity area are widely accepted. Commonly used systems are CO(2), argon, KTP and erbium devices. The disadvantages are heat development and/or acoustic load of the inner ear. A new laser with ultra short pulses was examined concerning its ablation characteristics and tested for possible applications in the tympanic cavity. METHODS: Investigations on human ossicles and porcine compacta were performed with a femtosecond laser in order to determine the ablation parameters. This included measurements of the dependency of the threshold energy on the pulse duration and the determination of the ablation ratio using different pulse energy levels. On the basis of histological slices the thermal damages of the bone were examined. Additionally, the processed samples were analyzed with an optical microscope and with a scanning electron microscope in order to evaluate the quality of the perforations. RESULTS: The measurements showed that the threshold energy has a lower level than the threshold energy of the conventional laser systems. At a pulse duration of 180 fs the smallest fluence, with which an erosion can be achieved, is below 1 J/cm(2). With increasing pulse duration the necessary threshold energy also rises. Due to the low energy level necessary for ablation and the extremely short pulse duration, less thermal damage is induced to the surrounding bone tissue as compared to conventional laser systems. The analysis of the scanning electron microscope demonstrates the extreme precision of this laser system. The achieved accuracy of the incisions and drillings ranges in the microm-area. CONCLUSIONS: The fs laser represents a new surgical tool for middle ear surgery. It works efficiently and in a touch-free procedure. Due to its high precision and the reduced side effects an advantage in the handling of bony structures is to be expected in relation to other laser systems. Apart from the perforation of the stapes footplate, in particular the handling and modelling of the incus, a further field of applications includes enhanced coupling, e. g. for implantable hearing aids and ossicular chain replacement prosthesis.

Animals↗
PubMed1999

Endoscopic middle ear surgery.

One hundred sixty-five middle ear procedures were performed with an endoscope, a camera, and a video monitor instead of the microscope. The endoscope offers the following advantages: 1) it visualizes the whole tympanic membrane and the ear canal without having to manipulate the patient's head or the microscope, 2) it extends the operative field in transcanal procedures into structures usually hidden from the microscope (anterior tympanic perforation, posterior retraction pocket, facial recess, and hypotympanum), and 3) it visualizes structures from multiple angles as opposed to the microscope's single axis along the ear canal. Disadvantages of the endoscope include the one-handed surgical technique, a loss of depth perception, limited magnification, and the need for training. The endoscope holds the greatest promise in tympanoplasty and cholesteatoma surgery and should increase the utilization of transcanal over postauricular procedures.

Audiometry↗
PubMedDate not supplied

[Introduction to the surgery of the middle ear: general principles].

We study the basic guidelines of the middle ear surgery, having as target the recuperation of the anatomic functional integrity of ear. There are different important elements in the quality/quantity of the functional results as follows: The surgery technical method used. The actual pathology in the middle ear. The quality of eustachian tube function. The surgeon's experience and ability and several factors. We review the concept introduced by Wullstein called it tympanoplasty from 1952 till nowadays. Finally, we described the most frequent surgery procedures used in the daily practice.

Ear Diseases↗
PubMed1983

[Complications of stapedectomy].

The authors present here the usually less developed complications of stapedectomies: postoperative cochlear drops, tinnitus, vertigo. They also mention the other complications of stapedial surgery. They insist particularly on the interest of half posterior platinectomy technique, associated with a sufficiently large venous interposition.

Audiometry↗
PubMed1985

Facial palsy following stapedectomy: (a case report).

A case of peripheral facial palsy which appeared 8 days following ipsilateral stapedectomy, was diagnosed as Bell's palsy. We stress the uncommon coincidence of the two events and the important implications in the treatment of a palsy appearing after middle ear surgery. Bell's palsy is an unusual but real possibility which should be borne in mind before deciding on extended surgical exploration.

Adult↗
PubMed1984

Histopathology of the stapes in otosclerosis.

A histopathological examination was made of 60 stapes obtained during surgery for clinical otosclerosis. The findings, correlated with the clinical history and macroscopic appearances of the stapes, led to the following observations. The histological extent of the focus of otosclerosis agrees well with the macroscopic appearance of the footplate lesion seen under the operating microscope. The earlier the age of onset of hearing loss the greater the probability of active, severe and diffuse otosclerotic involvement of the footplate. Two-thirds of the cases with diffuse and severe footplate otosclerosis had signs of active disease. A late age of onset of clinical otosclerosis tends to be associated with lesions that are limited to the anterior pole of the stapes footplate. Active otosclerosis is rare in these cases. The case for macroscopic increase in extent of the lesion with time could not be established by the data. The evidence supports the view that the severity and extent of otosclerotic disease in the footplate is determined more by age at onset than by duration of symptoms. Healing of the active focus of otosclerosis may not always occur despite a long duration of symptoms. A highly active focus in the stapes footplate can remain active for many years.

Ear Ossicles↗
PubMed2000

[Surgical treatment of otosclerosis with argon laser].

OBJECTIVES: Argon laser stapedotomy is a new modality for the treatment of otosclerosis. The first results obtained in Denmark are reported. MATERIALS AND METHODS: A retrospective follow-up study was undertaken to evaluate the results of argon laser stapedotomy which was introduced in 1991 at the department of Otolaryngology, Rigshospitalet, Copenhagen. The results are based on 85 consecutive primary stapedotomy operations with argon laser in 76 patients during the period January 1, 1991 to June 30, 1996. Mean follow-up was 16.6 months (6-60). RESULTS: The postoperative air-bone gap was closed within 10 dB or less in 83% of the operations and in 20 dB or less in 98%. The mean speech reception threshold (SRT) was 48 dB preoperatively. All patients had an improved SRT after the operation, with a mean value of 23 dB. At 4000 Hz and 8000 Hz, 89% and 65% of the patients had maintained or improved their hearing. No patient developed profound sensorineural hearing loss or anacusis after the operation. Only one patient developed symptoms of a temporary perilymphatic fistula. CONCLUSION: Argon laser stapedotomy is a safe technique. Its complications are fewer and not as serious as conventional methods. In addition, the achieved hearing results are better, and thus it is a good example of "minimal invasive high success surgery".

Adolescent↗
PubMed1994

[Analysis of the results of hearing improvement after bilateral stapedectomy].

The authors present the results of hearing improvement in a group of 50 patients who underwent bilateral stapedotomy. For the estimation of hearing improvement after the surgery the following criteria were used: 1. a comparison of air and bone conduction thresholds before and after the surgery, 2. an airbone gap before and after the surgery according to Toss, 3. hearing improvement index and 4. bilateral hearing loss index.

Adolescent↗
PubMed1984

Long-term results of bilateral stapedectomy.

Bilateral stapedectomy was performed in 122 cases of bilateral otosclerosis at Ulleval Hospital between 1960 and 1978. Ninety-six patients (192 ears), or 79 per cent, were re-examined in 1980. The long-term results showed that the air/bone gap was closed to within 10 db. in 142 ears (74 per cent). Twenty-four patients (25 per cent) used a hearing aid at the time of the examination, mainly because of presbyacusis. Deafness or serious sensori-neural loss ascribed to the operation was found in 21 ears (11 per cent). Immediate deafness occurred in three ears (1.5 per cent), and in seven ears (3.7 per cent) the patient became deaf later. Eleven ears (5.8 per cent) had marked sensori-neural losses, but with some speech comprehension. None of the patients had bilateral deafness, but one patient was deaf in one ear, with a sensori-neural loss of 80 db. in the other. Eleven patients (13 ears) who had undergone previous stapediolysis or crurotomy, were treated as a separate group, and their results were compared with those obtained in the other patients. We have also tried to find out if there is any difference between the long-term results of surgery in the first and in the second ear.

Adolescent↗
PubMed2000

Audit of stapedectomy in the north west of England for 1996 and an analysis of the criteria used to describe success.

A questionnaire was used to collect information related to stapedectomy from all the NHS Trusts in the North West region. The data collected included the identity and rank of the surgeon, the age and sex of the patients, the side of the operation, the audiometric values of the air conduction audiogram preoperatively and postoperatively, and an account of any complications. The results were analysed and compared to national and international standards. The criteria for analysis of success in surgery for conductive hearing loss were reviewed.

Adult↗