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PubMed1994

Otosclerosis.

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Audiology↗
PubMed1994

[Otosclerosis: study of the postoperative course of hearing during the first 5 years and research of some prognostic factors. Apropos of a series of 67 cases].

Post-operative air conduction and bone conduction thresholds at 3 months, 1 year and 5 years after stapedectomy or stapedotomy in 67 patients were studied. Bone conduction thresholds improved in the first year postoperatively, then decreased progressively, less than in the non-operated ear but more than in a normal population. The air-bone gap was closed in 75% of the patients. The air-bone gap stayed at the same level during the studied period. Air conduction and bone conduction thresholds are better in the stapedotomy group than in the stapedectomy group only in the 4000 Hz frequency, and are similar for both groups in the 500-2000 Hz range.

Adult↗
PubMed1993

Impedance transfer: acoustic impedance of the annular ligament and stapedial tendon reconstruction in otosclerosis surgery.

The resistance rebuilt around the lower tip of the piston must be the same as that created by the annular ligament of the stapes footplate. Otherwise, the threshold at which an acoustic or barotrauma is able to damage the membranes and hair cells of the inner ear will be lowered. The elasticity reestablished around the lower tip of the piston plays a part in the quality and quantity of hearing for the low frequencies up to 3 kHz. To protect the ear against acoustic traumas, an attempt to rebuild the stapedial reflex is proposed.

Acoustic Impedance Tests↗
PubMed1993

[Surgical treatment of otosclerosis. Long-term results].

UNLABELLED: At Glostrup Hospital, Copenhagen, exceptionally few stapedectomies were performed during the period 1979-1985. The audiological results five to eleven years after the operation were investigated in 64 patients. About half of the patients were operated using large fenester technique, the other half using small fenester technique. All patients but two were operated by the same expert surgeon. The initial results showed good stability with an unchanged median hearing gain of 30 dB. Eighty-five percent of the patients had an SRT < or = 35 dB HL in contrast to 89% at the 1-year follow-up (and five percent preoperatively). Eighty-two percent had an air-bone gap < or = 20 dB in contrast to 93% at 1-year follow-up (and 10% preoperatively). None of the patients had spontaneously developed severe sensorineural hearing loss, which was, however present in two patients as a direct result of the operation. In one of the patients it was caused by granuloma formation around the prosthesis, in the other patient it developed after a revision procedure. Both patients were operated using large fenester technique, which in general gave less satisfactory primary hearing improvement and less stable thresholds than small fenester technique. IN CONCLUSION: Even under conditions with few operations per year the overall long term results of stapedectomy are satisfactory when performed by few trained ear surgeons, and in particular if small fenester technique is used. The risk of sensorineural hearing loss is primarily related to the operation.

Adult↗
PubMed1993

Stapedectomy. Causes of failure and revision surgery in otosclerosis.

The greatest chance of success in stapedectomy is at the time of the initial procedure. Complications are compounded and successes markedly decreased when revision surgery is attempted. The most common pitfalls encountered in stapedectomy are reviewed in this article. Principles of surgery that have minimized complications and decreased the need for revision procedures in the authors' practices are outlined. Guidelines helpful when considering revision surgery also are presented and specific indications are addressed.

Humans↗
PubMed1993

[Otosclerosis].

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Ear, Middle↗