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At least 1,063 records · Page 59Linked to original sources
PubMed1990

Laser applications in ossicular surgery.

In the past 8 years, the author has used the laser in more than 2800 cases of tympanomastoid surgery. Of these, more than 600 involved middle ear ossicular surgery including otosclerosis, congenital deformities, and fixations of the ossicular mass for various reasons. During this time, there have been no complications, either short-term or long-term, associated with the use of the laser. There are many tasks the laser can perform with less trauma, more precision, and greater speed than conventional hand-held tools. The laser does not replace these tools in otologic surgery, but it does add an instrument that allows the microsurgeon to perform difficult tasks with greater ease and confidence.

Ear Diseases↗
PubMed1989

[Stapedectomy. Audiometric considerations and results].

Perusal of the last 100 stapedectomies done in the ENT Service of the AA. (Social Security Hospital. Cuenca) displaying audiometric outcomes. Considerations related to the etiology, the surgery and other items of the disease are dealt with.

Adult↗
PubMed1993

Do magnesium infusions protect the inner ear during middle ear surgery? A randomized double blind study.

Joachims et al. recently demonstrated that magnesium was able to protect the inner ear during exposure to noise and fire arms. During middle ear surgery, the inner ear is subjected to noise from fraising and drilling. We saw fit, therefore, to conduct a random double blind study to establish whether magnesium infusions would protect the inner ear during middle ear surgery. We examined 80 patients (38 verum, 42 placebo). The verum patients received 10 mg/kg body weight magnesium 12 hours and 1 hour prior to operation. Plasma and red cell magnesium levels were measured pre-operatively and intra-operatively; they rose as expected. Post-operative auditory tests showed that magnesium had no tendency to prevent inner ear damage. Advocates of magnesium criticize the limited number of patients in our study as well as the administration of the magnesium substitute. In our opinion, however, it should be borne in mind when evaluating these findings that noise from drilling and fraising is only one factor among many which can induce inner ear injury during middle ear surgery.

Adult↗
PubMed1994

Iatrogenic facial nerve injury during otologic surgery.

Perhaps the most devastating complication in otologic surgery is that of inadvertent injury to the facial nerve. A review of 22 patients who had sustained an iatrogenic facial nerve injury was conducted. Although the most common procedure being performed during the injury was mastoidectomy (55%), a surprising number of patients had injury during tympanoplasty (14%) or during removal of exostoses (14%). The most common area of injury to the facial nerve in this series was in the tympanic segment. In 79% of the patients, the facial nerve injury was not detected at the time of surgery. All patients underwent surgical exploration of the facial nerve. Otologic surgeons are cautioned to be familiar with the normal course of the facial nerve and to be aware of the potential for facial nerve injury when performing transcanal surgery.

Adolescent↗
PubMed2003

[Glasgow Benefit Plot for evaluation of stapedectomy result].

In a group of 153 patients, the result of unilateral stapedectomy was evaluated using Glasgow Benefit Plot. Pure tone average at frequencies 0.5; 1; 2; and 3 kHz of operated and non-operated ear were used to distribute patients to pre- and post-operative groups. In 26 (79%) of 33 patients with unilateral hearing loss, bilateral normal hearing was achieved. Thirty one (46%) of 68 patients with asymmetric bilateral hearing loss and 37 (71%) of 52 patients with symmetric bilateral hearing loss had unilateral normal hearing after the operation. Twenty (29%) patients of the group III had bilateral symmetrical hearing loss after surgery. Stapedectomy was less beneficial for 17 (25%) of 68 patients with asymmetric hearing bilateral loss and 15 (29%) 52 of patients with symmetric bilateral hearing loss, who still had asymmetric hearing loss after the operation. Evaluation of hearing tests using the Glasgow Benefit Plot enables to evaluate patient's hearing disability and to predict possible benefit from surgery for individual cases.

Adolescent↗
PubMed2001

[Anticholinergic syndrome after postoperative dimenhydrinate administration].

Appearance of an anticholinergic syndrome after treatment with drugs in therapeutic dosages is seldom reported in the literature. Based on a case report, the development and course of an anticholinergic syndrome after treatment with dimenhydrinate are described. The drug was given due to different symptoms such as vertigo and vomiting after surgery. The anticholinergic syndrome could successfully be treated with physostigmine.

Adult↗
PubMed1988

[Perilymphatic fistula. Diagnostic and therapeutic difficulties].

The symptoms and signs of perilymphatic fistulae (PLF) are very varied and frequently misleading. The operative demonstration of a perilymph leak is not always obvious and the therapeutic results are sometimes disappointing. The study of 26 cases demonstrates certain concepts concerning the diagnostic and therapeutic difficulties. Any atypical cochleovestibular symptoms, particularly occurring in a traumatic context, should suggest the possibility of PLF. Exploratory surgery must be performed according to a rigorous protocol in order to demonstrate the fistula. Search for a fenestra ovalis sign due to pressure on the membrane of the fenestra rotunda may help to reveal a lesion of the annular ligament. Simple filling of the breach is not always effective, especially at the level of the stapes. Stapedectomy frequently constitutes the best solution for fistulae of the fenestra ovalis.

Adult↗
PubMed2000

Long-term results in otosclerotic patients operated by stapedectomy or stapedotomy.

Stapedectomy and stapedotomy are the techniques currently used in the surgical treatment of otosclerosis. During the period 1977-81, a total of 60 consecutive patients were subjected to surgery for otosclerosis according to the method of Schuknecht (Gelfoam and wire prosthesis). Another 55 consecutive otosclerotic patients were operated on during 1987-91with stapedotomy, according to the method advocated by Fisch (Fisch-type piston). Independent of the surgical technique used, the maximal hearing gain was obtained 1 year after surgery. In the frequency range 0.5-3 kHz, the mean value of the averaged pure tone thresholds improved from 52 to 28 dB in the stapedectomy group and from 57 to 26 dB in the stapedotomy group. In the frequency range 4-6 kHz, the subjects' hearing was not significantly improved in the stapedectomy group, whereas the subjects' hearing in the stapedotomy group improved from 61 to 44 dB. Per- and postoperative complications were low in both groups, except for one patient in the stapedectomy group who experienced the serious complication of a deaf ear after surgery.

Adult↗
PubMed2006

[Observation of tympanosclerosis operation result].

OBJECTIVE: To assess effects of multi-technique operation for tympanosclerosis. METHOD: A retrospective analysis of 157 cases (167 ears)of tympanosclerosis (the cases with only tympanic membrane calcification were excluded) was undertaken. All patients received the multi-technique if needed: (1) Open the attic, mastoid antrum etc; (2) Rebuild scute with auto-bone or infill the mastoid cavity with auto bone pieces; (3) Preserve or reconstruct the ossicular chain; (4) Utilize the absorbable Merogel to prevent re-adhering; (5) Press prostheses with tympanic chorda nerve as a spring; (6) Clear out hyperplastic bone on facial canal with Er-laser or small chisel. Postoperative audiometric measurements were undertaken within one month. And the follow up audiometric measurements were performed at three months after surgery, and then every half or one year later again. The last evaluations were considered as the results of follow up (taking the average hearing threshold at 0.5, 1.0, 2.0 kHz HL). RESULT: The mean air-bone gap (ABG) of 167 ears was (39.74 +/- 12.54) dB before operation, while it was elevated to (20.68 +/- 11.80)dB after operation (P < 0.01). Surgical treatment was found to be successful in seventy-one ears (42.5%) and effective in forty-eight ears (28.7%). The total effectiveness was 71.3% (119 ears). Followup result was (20.67 +/- 13.52) dB, compare with pre-operative hearing threshold (P < 0.01). However, it had no difference comparing with post-operative hearing threshold (P > 0.05). Of 96 ears which were followed up over 1 year, the average ABG was (21.94 +/- 11.16) dB comparing with that of the total 167 ears follow up result (P > 0.05). CONCLUSION: Using multi-technique can obtain better and consistent hearing results. Surgery for total ossicular chain fixation of tympanosclerosis is still difficult. Stapedectomy still needs to apply in tympanosclerosis cautiously.

Adolescent↗
PubMed2002

Nasal and hearing impairment: are they linked?

Hearing impairment is the most prevalent sensory deficit in the human population. Otosclerosis and chronic otitis media are two of the most frequent causes of hearing loss of the Western world and both benefit from middle ear surgery. The success rate is high for both operations, in expert hands, but, in our clinic and in every ENT clinic, there remains a percentage of failure. Some of the most frequent post-operative complications can lead to tubal dysfunction. We believe that a correct and complete evaluation of the rhino-pharyngeal-tubal unit is very important before tympanoplasty and stapedioplasty in order to further reduce the incidence of some post-operative complications and to increase the success rate of middle ear surgery. What is well known in medicine, 'prevention is the best therapy', seems not oddly observed in ear surgery, where is usually operated the effect, while the evaluation and therapy of the causes seems to be underestimated.

Eustachian Tube↗
PubMed2004

Hearing outcome of laser stapedotomy minus prosthesis (STAMP) versus conventional laser stapedotomy.

OBJECTIVE: The objective of this study was to compare short-and long-term hearing outcomes for patients undergoing primary laser stapedotomy minus prosthesis (STAMP) versus conventional laser stapedotomy. STUDY DESIGN: We conducted a retrospective case review of 167 consecutive patients from 1993 to 2002. SETTING: Otology/neurotology tertiary referral center. PATIENTS: We studied those with clinical otosclerosis without previous otologic surgery. INTERVENTIONS: Patients with otosclerosis confined to the fissula ante fenestram underwent STAMP. Patients with more extensive otosclerosis or anatomic contraindications to STAMP underwent standard laser stapedotomy. MAIN OUTCOME MEASURES: Pure-tone audiometry was performed before surgery, postoperatively, and on routine follow-up examination. RESULTS: Of the 183 ears in 167 patients, 128 (67.1%) underwent laser stapedotomy and 55 (32.98%) underwent STAMP. The STAMP mean air-bone gap (ABG) closed from a preoperative value of 22 dB (standard deviation [SD], 10 dB) to 6 dB (SD, 7 dB) on average follow up of 778 days. In 128 laser stapedotomy patients with an average follow up of 747 days, the preoperative mean ABG closed from 27 dB (SD, 10 dB) to 8 dB (SD, 7 dB). There was a trend toward improvement in high-frequency air conduction thresholds after STAMP versus worsening of high-frequency thresholds in the conventional stapedotomy group. There was a statistically significant improvement in most recent postoperative high-frequency (6000-8000 Hz) air conduction thresholds in the STAMP patients compared with patients who underwent conventional laser stapedotomy. CONCLUSION: Laser STAMP, when used for isolated anterior footplate otosclerosis, provides excellent high-frequency hearing, yields lasting results similar to conventional laser stapedotomy, and has a low incidence of refixation necessitating revision surgery.

Adolescent↗
PubMed1990

[Preservation of the stapedial muscle in the treatment of otospongiosis, apropos of 48 cases].

The surgical management of otosclerosis, using drilling of the foot plate with a 8 mm diamond burr, 4 mm diameter, teflon prosthesis and vein graft, seems to be in our experience the safest procedure. However, we have tried to keep the function of the stapedial muscle in 48 patients to study the effects on hearing improvement, the stapedial reflex conservation, the protection of inner ear during the six months after surgery. The original technique and results are reported. After surgery, we have not observed any case of painful amplified hearing or of resonance. The audition is reestablished like with the usual techniques.

Audiometry↗