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At least 19 recordsLinked to original sources
PubMed1976

Ossicular reconstruction in tympanoplasty - mobile stapes without crural arches, fixed stapes with and without crural arches.

A description of ossicular reconstruction in problems with the stapes using autograft and/or homograft ossicles is given. The inverted stapes is employed for otosclerosis and tympanosclerosis. The two ossicle reconstruction is used in cases of a mobile footplate with absent crural arches. The reshaped incus is repositioned between the malleus handle and oval window when the stapes is fixed and there also exists a lateral ossicular chain defect. Loose connective tissue is an effective seal for the oval window and is a means of stabilizing ossicular functions.

Humans↗
PubMed1977

Postinflammatory osteogenic fixation of the stapes.

Stapes fixation existing with chronic otitis media has been attributed usually to either tympanosclerosis or concomitant otosclerosis. A different type of stapes fixation has been encountered which the author has termed "post-inflammatory osteogenic stapes fixation." One thousand five hundred and two surgical procedures for chronic otitis media were reviewed with 112 rigid stapes fixations found of which 19 were classified as post-inflammatory osteogenic stapes fixation. Surgical techniques were discussed, case histories were presented, and photomicrographs were shown illustrating two varieties of post-inflammatory osteogenic stapes fixations classified according to the side of the fixing lesion. The etiology and pathogenesis of this condition were felt to have a direct relationship to infection and prior surgery. Post-inflammatory osteogenic stapes fixation probably occurs more frequently than realized. Further research is needed to evaluate this type of stapes fixation.

Adolescent↗
PubMed1978

[Anomalies of the stapes (author's transl)].

Reported are four cases of anomalies of the stapes and the oval window niche. Their diagnostic and operative problems are discussed. The report includes one case of spontaneous cerebrospinal otorrhea. Surgical exploration of the middle ear demonstrated a fluid leak from a fistula in the stapes footplate. Two cases presented combined congenital anomalies of the stapes and facial nerve as a cause of hearing loss. Additionally one case of "columella" shaped stapes was observed. The embryological aspects of the middle ear structures are discussed.

Adult↗
PubMed1977

[On the oscillation form of the stapes as a function of the volume. Experimental investigations into the human temproal bone preparation (author's transl)].

In order to further clarify the change in the oscillation form of the stapes as a function of the volume, measurements were performed in 10 fresh temporal bone preparations at two points at the short and long diameters of the base of the stapes from the labyrinthine side. The oscillations were recorded from two channels, first, by two electro-dynqual stress on the base of the stapes, also optically by modulating a light beam and electronically scanning by means of a phototransistor, and the oscillations were then recorded on a two-beam oscilloscope. The result was that it is not possible to prove any phase shift between the two measurement points at the short or at the long base of the stapes in a volume range within the physiological limits. Thus, any sweep phenomenon at high volumes does not exist. Also, a volume-dependent shift of the oscillation axis on a line within the base was not to be observed.

Ear Ossicles↗
PubMedDate not supplied

A scanning electron microscopic study of the normal human stapes.

The structure of the normal human stapes was studied with the scanning electron microscope. Specimens were obtained 48 hours after death from adult human temporal bones free from obvious inflammatory disease. The specimens were fixed, dissected, critical-point dried and coated with gold. In this scanning electron microscopic study an attempt has been made to systematically demonstrate the average scanning electron microscopic features of various areas of the normal human stapes. An emphasis has been placed upon demonstrating as clearly as possible the details previously unclear or unrecognized and duplication of many excellent earlier light and electron microscopic studies has been attempted. The typical appearance of the stapes head, neck, arch, crura and footplate has been presented. It is apparent that there exists a high degree of structural specialization particularly in the stapes arch and footplate area.

Ear Ossicles↗
PubMed1992

Tympanosclerosis of the stapes: hearing results for various surgical treatments.

When tympanosclerosis involves the tympanic membrane or the lateral ossicles, treatment is usually straightforward and uncomplicated. When the stapes is involved, therapy is more controversial and may be more difficult. We report our results in 154 patients who underwent different surgical procedures for tympanosclerosis of the stapes. Followup was up to 10 years. Pure-tone average threshold was significantly improved (p < 0.05) in patients who underwent mobilization procedures or stapedectomy for definitive treatment. The air-bone gap was less than 20 dB at 6 months postoperative in 72% of patients and less than 30 dB in 90%. At 6 months, 2 years, and 5 years there were no statistically significant differences in hearing results between stapedectomy and mobilization patients, some of whom were followed for up to 10 years. No patient had a profound hearing loss after surgery. Surgical treatment for tympanosclerosis of the stapes is a safe procedure, with hearing results similar to those of surgery for other chronic ear diseases involving the ossicular chain.

Adult↗
PubMed1991

Surgery for congenital stapes ankylosis with an associated congenital ossicular chain anomaly.

The surgical findings and results are presented on 32 ears with congenital stapes ankylosis with an associated congenital anomaly of the ossicular chain. One third of the patients had a syndromal diagnosis. In 26 ears, stapedectomy could be performed. In 2 other ears, stapes ankylosis to the bony facial canal was mobilized successfully. In the 4 remaining ears, surgical intervention had to be limited to an exploratory tympanotomy for various reasons. The average hearing gain was 23 dB for the 28 ears on which stapes surgery had been performed. A substantial hearing gain of at least 15 dB was achieved in 19 of these 28 ears (68%). The end result was limited to a small extent by an average preoperative sensorineural component of 16 dB in the hearing loss. A review of the findings and results from other larger series in the literature are presented.

Adolescent↗
PubMed1976

The use of homograft stapes.

Homograft stapes were used for ossicular reconstruction in 43 ears over a three-year period. The average hearing improvement was 7.9 db. These cases were divided into groups: those with an intact posterior canal wall and those with an open mastoid cavity. The latter group fared better, with an average improvement of 15 db. Fourteen of the 43 ears were subsequently re-explored. Satisfactory bony union between the homograft stapes and recipient footplate was found in eight cases, four cases showed poor bony union, and bony resorption of the homograft had occurred in two patiemise for reconstruction of the ear with a loss of the stapes arch, especially in the presence of an open mastoid cavity and thus a shallow middle ear.

Ear Ossicles↗
PubMed1991

[Stapes dislocation and opening in the inner ear due to tympanoplasty].

During tympanoplasty, the stapes is often exposed to considerable manipulations, i.e. the dissection of cholesteatoma matrix from the oval window niche or the insertion of a prosthesis for ossicular chain reconstruction. Too much strain may rupture the annular ligament resulting in an opening of the inner ear. Furthermore it is conceivable that microperilymphatic fistulas, which remain undetected, may develop prior to a visible luxation of the stapes. Therefore, temporal bone experiments with definite manipulations on the stapes were performed to study the rupturing strength of the annular ligament. Increasing the pressure of the methylene blue dyed perilymphatic fluid facilitated the detection of even smallest ruptures. A leakage occurs only in case of a complete rupture of all fibres. Further findings of clinical interest, gained from these experiments with different directions of stapedial manipulation, are discussed.

Ear, Inner↗
PubMed1992

Allograft stapes-incus assembly. Long-term results.

In 35 patients with absence of the stapedial arch, with a history of radical surgery, and without ossicles, the head of an allograft stapes was placed on the patients' footplates and an allograft incus body on the top of this. The long-term results of this assembly, judging by different methods of analysis, are still somewhat better than those of 98 ears with approximately the same pathologic condition treated by an allograft incus as the columella between the footplate and fascia. The allograft stapes-incus assembly is an alternative method to the commonly used incudal columella. The allograft stapes has not been resorbed to a significant degree during the years after surgery.

Ear Ossicles↗
PubMed1991

The learning curve in stapes surgery.

Fewer stapes operations are available to train residents and to maintain individual competence. Most residents in the United States perform 0 to 10 cases during training, and produce results which are not as good as expert results, even with close supervision. After graduation, fewer cases are available to achieve expert results in private or academic practice. The authors' conclusions and recommendations are based on his own learning curve. Residents who have below average skills in middle ear surgery, and residents who do not wish to practice otology, should watch but not perform stapes surgery. Program directors, collectively or separately, should develop more formal guidelines for teaching stapes surgery during residency.

Clinical Competence↗
PubMed1978

Homograft stapes in middle ear surgery.

Descriptions are given of various uses of stapes homografts in tympanoplasty on ears with missing stapedial arch. The use of homograft stapes-incus assembly, placing the head of the homograft stapes on the patient's own footplate and on top of that an incus, is a method which at long sight has proved to afford better results than the use of an incus columella.

Ear Ossicles↗
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↗
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↗
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↗
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↗
PubMed1977

Surgery and histopathology of the stapes in osteogenesis imperfecta tarda.

Fourteen stapedectomies were performed on ten patients with osteogenesis imperfecta tarda. Clinically, the footplates were softer and more tenuously fixed than in otosclerosis and floating footplates seemed more common. Stapes and stapes fragments from all 14 operations were examined microscopically. The histopathology of osteogenesis imperfecta was contrasted to that of otosclerosis. We believe that the greater degree of structural disorganization and greater area occupied by resorption spaces clearly distinguish the new bone formed in osteogenesis imperfecta from otosclerosis.

Adolescent↗
PubMed1978

Allograft stapes-incus assembly. A new ossiculoplasty.

In 45 patients with absence of the stapedial arch, including 24 with a history of radical surgery and without ossicles, the head of an allograft stapes was placed on the patient's footplate and on top of this an incus body, either as allograft or autograft. The results of this assembly, judging by different methods of analysis, are the same as in 45 ears having approximately the same pathologic condition treated by an autograft or allograft incus as the columella between the footplate and eardrum. The allograft stapes-incus assembly is an alternative method to the commonly used incudal columella, particularly in patients previously subjected to radical surgery in whom all ossicles are absent.

Ear Ossicles↗