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At least 163 records · Page 9Linked to original sources
PubMed2006

Patient's quality of life and hearing outcomes after stapes surgery.

OBJECTIVES: To determine the quality of life (QOL) after stapes surgery and whether audiological parameters for hearing correlate with specific QOL factors. DESIGN: A retrospective cross-sectional study. SETTING: A tertiary referral centre. PARTICIPANTS: A series of 35 patients who underwent stapes surgery of which three were excluded because they were <18 years of age, chronically or mentally ill, or in a dependant relationship. Response rate was 93% (30/32). Nine were further excluded because they had revision or bilateral surgery, or missing data. Twenty-one patients were included in this study. MAIN OUTCOME MEASURES: The Glasgow Benefit Inventory (GBI) was used to evaluate general QOL and the Hearing Disability and Handicap Scale (HDHS) was used as a disease-specific measure. The Belfast Rule of Thumb and Glasgow Benefit Plot assessed hearing outcomes. RESULTS: Operative success was 86% using the Belfast Rule of Thumb and 95% had closure of the air-bone gap to within 20 dB. 81.8% of patients reported a better overall QOL as surgery. Glasgow Benefit Inventory Social and GBI Physical scores correlated positively with the HDHS speech component (P < 0.05). The duration of hearing loss correlated inversely with the average HDHS score (P < 0.05). CONCLUSION: The majority of patients report a better QOL as undergoing stapes surgery. Speech impacts on people's physical and social QOL of patients. Quality of life tools, in addition to objective audiologic measurements can provide clinicians with patients' subjective perspective that helps guide clinical decision-making and counselling.

Activities of Daily Living↗
PubMed2006

The effect of superior-canal opening on middle-ear input admittance and air-conducted stapes velocity in chinchilla.

The recent discovery of superior semicircular canal (SC) dehiscence syndrome as a clinical entity affecting both the auditory and vestibular systems has led to the investigation of the impact of a SC opening on the mechanics of hearing. It is hypothesized that the hole in the SC acts as a "third window" in the inner ear which shunts sound-induced stapes volume velocity away from the cochlea through the opening in the SC. To test the hypothesis and to understand the third window mechanisms the middle-ear input admittance and sound-induced stapes velocity were measured in chinchilla before and after surgically introducing a SC opening and after patching the opening. The extent to which patching returned the system to the presurgical state is used as a control criterion. In eight chinchilla ears a statistically significant, reversible increase in low-frequency middle-ear input admittance magnitude occurred as a result of opening the SC. In six ears a statistically significant reversible increase in stapes velocity was observed. Both of these changes are consistent with the hole creating a shunt pathway that increases the cochlear input admittance.

Animals↗
PubMed2000

No evidence of measles virus in stapes samples from patients with otosclerosis.

Otosclerosis is a localized bone dystrophy of unknown etiology mainly involving the stapes. The hypothesis of a persistent infection by the measles virus was based on the inconstant detection of the virus by various methods, including reverse transcription-PCR (RT-PCR) of patients' stapes samples. The aim of this work was to investigate the presence of the measles virus in stapedial otosclerosis foci by different sensitive methods. Pathologic stapes samples were obtained from 35 patients suffering from otosclerosis. Measles virus detection was performed by (i) cocultures of Vero cells and primary cell cultures of bone samples (n = 7), (ii) immunofluorescence study of these cocultures (n = 3), and (iii) RT-PCR on RNA directly obtained from fresh frozen samples (n = 28) and on RNA extracted from the primary cell cultures (n = 2). Viral genomic regions coding for N (nucleoprotein) and M (matrix) proteins were separately amplified. PCR sensitivity was optimized on the measles virus Edmonston strain. Glyceraldehyde-3-phosphate dehydrogenase mRNA was used as a marker of total RNA recovery. PCR products were tested by Southern blot hybridization technique to improve sensitivity and specificity. PCRs amplifying the M and the N protein genes were able to detect the control measles virus RNA at titers as low as 0.1 and 0.01 50% tissue culture infective dose, respectively. With these highly sensitive methods, we could not evidence the presence of the measles virus in any of our bone samples or primary bone cell cultures. Our results do not confirm the hypothesis of persistent measles virus infection in otosclerosis.

Adult↗
PubMed2006

The effect of methodological differences in the measurement of stapes motion in live and cadaver ears.

Methodological differences in sound-induced stapes velocity (Vs) measurements in live and cadaveric ears were examined using fresh cadaveric temporal bones. On average, differences in preparation (sectioning the stapedius tendon, removing the facial nerve, and widely opening the facial recess) had statistically insignificant effects on measured Vs. Differences in the achievable measurement angle (with respect to the axis of piston-like stapes motion) had a significant effect on measured Vs below 2 kHz. These results suggest that much if not all of the differences in Vs measurements between live and cadaveric ears can be explained by the differences in measurement angle between the two preparations. Measurement angle was found to have minimal effect on measured Vs above 2 kHz. This demonstrates that the commonly used method of estimating stapes translational velocity by dividing the measured velocity by the cosine of the measurement angle is not valid above 2 kHz.

Aged↗
PubMed1977

Automatic audiometry in stapes motility evaluation.

An automatic Grason-Stadler-Békésy 1701 audiometer with continuous frequency progression (1 octave/min) and increase (or attenuation)of intensity of 2.5 dB/sec, has been employed to perfect an investigation technique for obtaining, by the mean difference in dB between absolute bone conduction (ABC) and relative bone conduction(RBC), a quantity evaluation of stapes motility and monitor alterations brought on by various disease processes. A preliminary study performed on subjects with normal hearing was used to establish the influence of age on motility. It was thus possible to establish an index (stapes motility index, SMI) to represent the degree of normal stapes motility as a function of the subject's age and thus, through variations in this index, identify alterations to the motility of the tympano-ossicular system caused by ongoing disease processes and by surgery.

Adult↗
PubMed2003

Fixation of the anterior mallear ligament: diagnosis and consequences for hearing results in stapes surgery.

In the search for possible causes of unfavorable results after stapes surgery, the study reported here focused on the anterior mallear ligament, since it has been previously reported that partial mallear fixation (PMF) leads to functional failure in 38% of cases of stapes revision surgery. The aims of the study were to identify effective methods for the diagnosis of PMF and experimentally assess the conductive hearing loss that results from PMF. The study included vibration amplitude measurements of the ossicles by laser Doppler interferometry (LDI) in 19 patients and 5 fresh human temporal bone (TB) specimens. Analysis of their dynamic behavior was performed by finite element modeling (FEM). Similar, significant changes of manubrium vibration patterns for PMF were found by FEM calculations, in TB experiments, and in patients. We could identify PMF either before operation, using LDI, or during operation, by manual palpation. In the TB experiments and FEM calculations, the attenuation of the stapes displacement due to an isolated PMF was approximately 10 dB and frequency-dependent. Untreated anterior mallear ligament fixation produced a persistent air-bone gap of approximately 10 dB after stapedioplasty.

Acoustic Impedance Tests↗
PubMedDate not supplied

Otosclerotic stapes: morphological and microchemical correlates. An electron microscopic and x-ray analytical investigation.

A total of 32 otosclerotic stapes is thin-sectioned without decalcification and examined using transmission and scanning electron microscopes, with a nondispersive x-ray analyzer attached to the latter. These otosclerotic stapes are classified as spongiotic, sclerotic, or preotosclerotic, accoring to their pathologic characteristics and state of mineralization. Either diffuse or patchy demineralization in the ground substance appears to be the initial stage of otosclerosis, and this area coincides with preotosclerotic lesions (also known as blue mantle) in light microscopy. Therefore, it is interpreted that demineralization precedes the destruction of ground substance in the preotosclerotic lesion. Bone mineral deposits in new otosclerotic bone appear to be related to the collagen fibrils that are embedded in the ground substance. No mineral deposit could be seen without the ground substance deposition; therefore, it is suggested that this ground substance is the single most important factor in the poor mineralization of the otosclerosis. The sclerotic lesions are well mineralized and show a typical pattern of hydroxyapatite by x-ray diffraction study. We could not confirm the notion that the sclerotic lesion is hypermineralized as compared to the normal stapes. The spongiotic lesions are poorly mineralized, with low calcium salt. Using the Ca/P ratio and x-ray diffraction pattern as criteria, it was determined that spongiotic lesions belong to unstable, immature bone.

Bone Marrow↗
PubMed2001

In vitro evaluation of a malleus head to stapes head 'incus replica' prosthesis.

An ossicular prosthesis produced by making a mould from a cadaveric incus and injecting ionomeric cement into it (incus replica prosthesis, IRP) has been cemented to the malleus head and stapes head and evaluated in fresh human temporal bones using a laser vibrometer. Stapes velocity was recorded under acoustic stimulation and foot plate displacements were derived. Fourteen frequencies between 125 Hz and 8000 Hz have been used. Measurements were made with the ossicular chain intact, following removal of the incus, with the prosthesis cemented to the malleus, but not the stapes, and with the incudo-stapedial joint cemented. In a second series of experiments the performance of the IRP was compared with that of a Causse partial ossicular replacement prosthesis, using the same experimental set-up. The results indicate that the prosthesis performs almost as well as the intact ossicular chain and that cementing the incudo-stapedial joint gives better sound transmission than leaving it uncemented. In addition the IRP outperforms the conventional partial ossicular replacement prosthesis.

Bone Cements↗
PubMed1991

Revision stapes surgery.

With the decline in primary cases of otosclerosis surgery, revision stapes operations are becoming a higher percentage of otosclerosis practice. Are the results from revision stapes surgery today comparable with those of surgeons trained prior to the present decline? A retrospective review of 559 consecutive stapes operations performed by the author revealed 109 revision operations. A retrospective review of these cases reveals that the most common cause for revision surgery was displaced prostheses and incus necrosis. The hearing results are dependent on the surgical pathology. In this series, the airborne gap was closed to less than 10 dB in 58% of cases, there were 64% of cases of displaced prostheses, and 57% of cases of incus necrosis, which is comparable with previously reported studies.

Cochlear Implants↗
PubMed1999

Teflon-wire piston or stainless-steel bucket stapes prosthesis: does it make a difference?

The goal of this study was to determine whether postoperative (implantation of a stapes prosthesis) hearing gain and the amount of air-bone gap overclosure are more improved with the Teflon-wire piston or with the stainless-steel bucket prosthesis. We retrospectively reviewed the outcomes of 82 surgeries that had been performed by the primary author; 41 of these patients had received a Fisch Teflon-wire piston, and 41 had received a Bailey-modified Robinson stainless-steel bucket prosthesis. The mean hearing gain for the patients who received the Teflon-wire piston was 23.3 dB after primary stapes surgery and 20.5 dB after revision surgery. Patients who received the stainless-steel bucket prosthesis experienced a mean hearing gain of 20.7 and 20.3 dB, respectively. Following primary stapes surgery, the air-bone gap overclosure was 4.4 dB with the Teflon-wire piston and 5.2 dB with the stainless-steel bucket prosthesis. There was no statistically significant difference in either hearing gain or air-bone gap overclosure between the two prostheses.

Adolescent↗
PubMed1997

[Long-term effects of stapes elevation].

To assess the clinical value of stapes elevation, 38 cases had been followed-up for 1-12 years (average 6.7 years). The results revealed that hearing improvement rate (over 10 dB) was 94.7% in short term and 86.8% in long term follow-up. The long term regression rate was similar to that in stapedectomy, and no severe sensorineural hearing loss occurred. In addition, the vestibular reaction was slight, especially in reoperated cases. The stapes elevation was easy to perform as compared with stapedectomy. Therefore, this technique may be the first choice for stapes surgery.

Adolescent↗
PubMed1999

[Samuel Rosen (1897-1981): the originator of stapes mobilization].

Samuel Rosen originator of the surgical procedure so called mobilization, was second only to Juliusz Lempert as one of the great modern discoverers of new surgical techniques in the treatment of otosclerosis. This was the result of a chance discovery during routine stapes mobility test of the ossiculat chain before fenestration. Rosen having had excellent scientific training and knowledge was well prepared to interpret accidental stapes mobility and so design a new surgical technique. This operation enabled thousands of patients with otosclerosis to regain their hearing. However, he did not receive widespread acclaim in his own country. He received many invitations from abroad, travelled to several countries around the world where he taught stapes mobility testing and demonstrated his surgical procedure. In 1957 he also visited Poland, where he was born. He did not however limit himself to microsurgery of the ear. He created a group of international scientists who on the basis of investigations carried out by some of them, in the quiet noiseless African bush demonstrated that not only hearing is protected and the ageing process of this sensory organ delayed but also the development of arteriosclerosis is slowed down that which is the root cause of more and more cases of heart disease which among other factors can be attributed to the noisy stress ridden world we live in. After much success and fame which he achieved throughout the world, the American Medical Association awarded Sam Rosen a gold medal in 1967. But this too was not widely accepted by all his colleagues in his own country. He died in 1981 in China.

History, 20th Century↗
PubMed2000

[Vertigo and objective vestibular symptoms in computer analysis of ENG in otosclerotic patients and after stapes operations].

The aim of this paper was evaluation of vertigo frequency in otosclerotic patients (group I N = 64) in comparison with control group (group II N = 20) and in people after stapedectomy (group III N = 64). Furthermore electronystagmographic recording spontaneous nystagmus, positional nystagmus were made. Computer analyses of ENG-recording and automatic calculation of directional preponderance and canal paresis were used. Vertigo was in 12% otosclerotic patients while in equal of age control group only in 5% subjects. Spontaneous nystagmus in 20% and positional nystagmus in 27% were recorded in otosclerotic patients while that took place in 10% and 15% control group respectively. Asymmetric reaction in-group I was in 21% cases and in 10% subject's in-group II. Real directional preponderance was in 18.8% otosclerotic patient's in-group I and it was absent in-group II. Obtained results revealed existence vestibule disturbances in otosclerotic patients. More frequent labyrinth objective symptoms were registered post stapedectomy. Vertigo in 21%, spontaneous nystagmus in 58%, positional nystagmus in 61%, asymmetric reaction in 48% was noted. Marks of vestibule and organ injury in otosclerosis and post stapedectomy were met. Vestibule disturbances were irritate and inconstant character. It is appears to be needed examination of balance system before stapedectomy in the planning of stapes operation and after operation on stapes. Presence of vestibular symptoms after stapes surgery is not cause less post stapedectomy improvement of hearing but sometimes postoperative improvement of hearing is better for lower frequencies in patients group with vestibular disturbances than in-patients without these symptoms.

Adult↗
PubMed1978

Histological development of stapes footplate in human embryos.

Normal development of the human stapes footplate was investigated in serial sections by light microscopy. Materials were obtained from 35 Japanese embryos from the 6th to 32nd week of embryonal age. Eighteen embryos up to 16 weeks of age (3.5mm to 105mm in crown-rump length) were examined, focusing particularly on the lamina stapedialis of the otic capsule. The present study showed that primordial formation of the lamina stapedialis appeared in 16mm embryo and that the lamina was completely formed and fused to the base of the annular stapes in a 35mm embryo. In a 50mm embryo, the adult form of stapes was found with a rim and annular ligament. The results, therefore, seemed to essentially agree with the theory of dual origin and development of the footplate proposed by Cauldwell and Anson, and teratogenic agents might affect any stage of the process producing anomalies, including congenital footplate fixation, congenital absence of the oval window and calcification of the annular ligament.

Ear Ossicles↗
PubMed2005

[Clinical study of a single congenital stapes malformation with possible X-linked dominant inheritance].

OBJECTIVES: To study the etiology of one Chinese pedigree with familial conductive deafness which was demonstrated involvement of X-linked dominant inheritance. METHOD: History of illness, physical examinations, pure-tone audiometry and acoustic and immittance measurement were obtained from members of this family. Some subjects received computed tomography scan of the temporal bone. The proband accepted chromosome karyotype analysis and operation with artificial stapes prosthesis. RESULT: The patients had normal physical examinations. Pedigree analysis indicated that they distributed four continuous generations and the number of female patients was larger than that of male patients. Only female patients can transmit the mutant gene to their later generations. Their audiological evaluation showed conductive hearing loss and acoustic immittance measurement showed A form curve. Two of them who underwent high-resolution CT scan had normal inner structures. In the operation for proband, we found that her stapes which was flat cylinder shape lacking staple footplate. Furthermore, her chromosome showed 46, XX. CONCLUSION: Patients with characteristics of congenital non-syndrome stapes fixation were identified in one large Chinese family. Pedigree analysis suggested a possible X-linked dominant inheritance in this pedigree.

Adolescent↗
PubMed1985

[Experience with fibrin glue in type-III tympanoplasty with stapes elevation].

In a retrospective study, type III tympanoplasties with stapes elevation on two groups of patients were compared. In group I (101 patients) the stapes elevations, the temporalis fascia grafts for tympanic membrane reconstruction, the grafts of periosteum and cartilage used for repair defects of the posterior bony meatal wall and the Stacke-II plasty replaced in its original position after tympanoplasty were also fixed with fibrin glue (Tissucol). Group II (control group of 102 patients) was operated with fibrin glue. In group I the fascial grafts of the tympanic membrane healed faster, more securely and without fewer complications. The external auditory canal however healed equally well in both groups. Early hearing results of type III tympanoplasty could be improved by fixing the stapes elevations with fibrin glue.

Audiometry↗
PubMed1985

Malleus to stapes assembly.

The malleus to stapes assembly is the ideal ossicular reconstruction because of its high degree of success. Unfortunately, both the malleus and the stapes have to be in good position to use this type of reconstruction making it much less common than other forms of ossiculoplasty. Over a six year period, 1976-1982, there were 20 such procedures performed, as compared to 85 cases of hemi-incus interposition ossiculoplasty in the same period. The malleus to stapes assembly technique and indications are described in this report. Reconstruction results show an 80% air-bone gap closure within 10 dB with an average improved speech reception threshold of 18 dB.

Adult↗
PubMed1980

Results of stapes surgery - subjective and objective.

A review of subjective and objective results of stapes surgery performed by one general otolaryngologist shows excellent correlation between the two. However, hearing results are poorer, and the complication rate higher than is usually reported. We recommend that patients be informed pre-operatively of the success rate and complication rate in the practice of their surgeon rather than the excellent results reported in the literature. Patients with unilateral hearing loss should be discouraged from undergoing stapes surgery. Approximately half of these patients do not obtain binaural hearing, and thus the success rate does not justify the risk of a complication. Further studies are required to determine whether stapes surgery should be performed only by otologists doing a high volume of such surgery.

Follow-Up Studies↗