Systematic review of the use of bone cement in ossicular chain reconstruction and revision stapes surgery

2014 ◽  
Vol 125 (1) ◽  
pp. 227-233 ◽  
Author(s):  
Inge Wegner ◽  
Jelle W.G. van den Berg ◽  
Adriana L. Smit ◽  
Wilko Grolman
Keyword(s):  
Systematic Review ◽  
Bone Cement ◽  
Ossicular Chain ◽  
Stapes Surgery ◽  
Ossicular Chain Reconstruction ◽  
Revision Stapes Surgery

Electrocoagulation improving bone cement use in middle-ear surgery: short-term and middle-term results

2016 ◽  
Vol 130 (12) ◽  
pp. 1110-1114 ◽  
Author(s):  
C Galy-Bernadoy ◽  
M Akkari ◽  
M Mondain ◽  
A Uziel ◽  
F Venail
Keyword(s):  
Bone Cement ◽  
Ossicular Chain ◽  
Stapes Surgery ◽  
Middle Ear Surgery ◽  
Hearing Improvement ◽  
Short Term ◽  
Ear Surgery ◽  
Middle Term ◽  
Ossicular Chain Reconstruction ◽  
Revision Stapes Surgery

AbstractBackground:Bone cement is used for ossicular chain repair and revision stapes surgery. Its efficient use requires cautious removal of mucosa from the ossicles. This paper reports a technique for easy, fast and safe removal of this mucosa prior to cement application. It consists of the application of monopolar electrocoagulation on the ossicles prior to bone cement application.Methods:The outcomes of six cases of revision stapes surgery and seven cases of partial ossiculoplasty, conducted between 2007 and 2012 using this new technique, were evaluated. Intra-operative reports and audiometric data were collected.Results:During the last assessment, reconstruction using bone cement resulted in mean post-operative air–bone gaps of 4.1 ± 6.5 dB in revision stapes surgery cases and 5.7 ± 5.5 dB in partial ossiculoplasty cases, reflecting a significant hearing improvement (p = 0.03). No complications were observed.Conclusion:Electrocoagulation allows the removal of mucosa from the ossicles in an easy, fast and safe manner, enabling the use of bone cement for ossicular chain reconstruction.

Use of Mimix hydroxyapatite bone cement for difficult ossicular reconstruction

2005 ◽  
Vol 132 (5) ◽  
pp. 727-734 ◽  
Author(s):  
Joel A. Goebel ◽  
Abraham Jacob
Keyword(s):  
Bone Cement ◽  
Medical Center ◽  
Case Series ◽  
Ossicular Chain ◽  
Successful Outcome ◽  
Speech Reception ◽  
Ossicular Replacement ◽  
Ossicular Chain Reconstruction ◽  
The Mean ◽  
Speech Reception Thresholds

OBJECTIVE: To describe the advantages of using MimixTM hydroxyapatite (HA) bone cement in reconstructing a variety of ossicular chain abnormalities. STUDY DESIGN AND SETTING: Case series at a tertiary medical center. RESULTS: Twenty-five cases of HA reconstruction are included in this series (ages 23-74; mean, 47 years). The examples presented include (1) HA as the sole reconstructive material for incus erosion, (2) HA for securing a total or partial ossicular replacement prosthesis, (3) incus augmentation after crimping for revision stapedotomy with incus erosion, (4) HA in primary stapedotomy to fix the crimped prosthesis to an intact incus, and (5) other unique situations. Preoperative and postoperative audiograms were evaluated for 4-tone pure tone average (PTA), speech reception thresholds, word recognition scores, and air-bone gaps (AB gaps). Mean follow-up was 11 months (range 2 to 22 months). The mean PTA improved from 57 dB to 37 dB, whereas the mean AB gaps decreased from 33 dB to 16 dB. There were no cases of infection or extrusion. CONCLUSIONS: Hydroxyapatite bone cement is an excellent adjunct or alternative to ossiculoplasty with preformed prostheses. Easily malleable, rapidly setting, and rapidly hardening, Mimix is particularly well suited for middle ear work. SIGNIFICANCE: Definitive fixation with bone cements during difficult ossicular chain reconstruction may ensure a more enduring successful outcome. (Otolaryngol Head Neck Surg 2005; 132:727-34.)

scholarly journals Outcomes in revision stapes surgery: ionomeric bone cement vs. malleostapedotomy in incus necrosis

2021 ◽  
Vol 4 ◽  
pp. 14-14
Author(s):  
Benjamin McOwan ◽  
Jason Wei Jun Lim ◽  
Wen-Shen Lee ◽  
Mark McOwan ◽  
Tim McLean ◽  
...  
Keyword(s):  
Bone Cement ◽  
Stapes Surgery ◽  
Revision Stapes Surgery

Bone Cement Fixation of Stapedotomy Prostheses: Long-term Outcomes in Primary and Revision Stapes Surgery

2020 ◽  
pp. 000348942097133
Author(s):  
Pedrom C. Sioshansi ◽  
Amy Schettino ◽  
Seilesh C. Babu ◽  
Dennis I. Bojrab ◽  
Eric W. Sargent ◽  
...  
Keyword(s):  
Word Recognition ◽  
Bone Cement ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
Revision Stapes Surgery

Objectives: To describe audiologic outcomes following hydroxyapatite bone cement fixation of stapedotomy prostheses. Methods: A retrospective case review at a tertiary neurotology referral center was performed of patients undergoing primary or revision stapedotomy between 2010 and 2017. Patients with hydroxyapatite bone cement fixation of stapes prostheses were assessed. Pre- and postoperative hearing was compared, consisting of air conduction (AC) and bone conduction (BC) pure-tone averages (PTA), air-bone gap (ABG), and word recognition scores (WRS). Short and long-term outcomes were assessed. Results: Forty-six patients with otosclerosis underwent stapedotomy with bone cement fixation: 21 primary cases and 25 revision cases, with an average follow-up time of 17 months. Mean AC PTA was 56 dB preoperatively, and 34 dB postoperatively ( P < .0001), while the ABG improved on average from 27 dB to 9 dB ( P < .0001). There was no significant difference in postoperative ABG between primary and revision stapes surgery (6 dB vs 10 dB, P = .07). These results persisted through long-term follow-up in a subgroup of patients with significantly longer follow-up time (mean 44 months). There was no significant change in BC PTA or word recognition scores. Three patients underwent subsequent revisions, one patient developed sensorineural hearing loss. Conclusion: Stapedotomy with bone cement fixation of the prosthesis provides excellent hearing outcomes in both primary and revision treatment of otosclerosis. Results are consistent and stable through long-term follow-up. The use of bone cement should be incorporated into the surgical armamentarium of the otologist for the prevention and treatment of loose-wire syndrome and incus necrosis.

Revision Stapes Surgery: A Critical Evaluation

1994 ◽  
Vol 111 (4) ◽  
pp. 473-477 ◽  
Author(s):  
Yasar Cokkeser ◽  
Maged Naguib ◽  
Miguel Aristegui ◽  
Essam Saleh ◽  
Mauro Landolfi ◽  
...  
Keyword(s):  
Fibrous Tissue ◽  
Critical Evaluation ◽  
Ossicular Chain ◽  
Oval Window ◽  
Tissue Reaction ◽  
Stapes Surgery ◽  
Surgical Trauma ◽  
Postoperative Results ◽  
Revision Stapes Surgery ◽  
Causes Of Failure

Fifty-six revision stapes surgeries performed during the last 9 years were evaluated retrospectively for their preoperative symptoms, intraoperative findings, and postoperative results according to the causes of failure, at the Gruppo Otologico, Piacenza, Italy. The most frequent causes of failure were found to be prosthetic misalignments, a reaction to the surgical trauma in the form of excess fibrous tissue reaction or new bony regrowth at the oval window, and ossicular chain problems. The location of the pathology was found to be an important factor in the outcome. Sixty percent of cases resulted in 0- to 20-dB air-bone gap. The causes of these failures, management, and their prevention during primary surgeries are also discussed.

Ossicular chain reconstruction: endoscopic or microscopic?

2021 ◽  
pp. 1-7
Author(s):  
E A Guneri ◽  
A Cakir Cetin
Keyword(s):  
Word Recognition ◽  
Middle Ear ◽  
Risk Index ◽  
Ossicular Chain ◽  
Recognition Score ◽  
Reconstruction Surgery ◽  
Ossicular Chain Reconstruction ◽  
Operation Duration ◽  
Air Conduction

Abstract Objective To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery. Methods Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air–bone gap, air–bone gap gain, word recognition score, mean operation duration and mean post-operative follow up. Results Post-operative air conduction, air–bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air–bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air–bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001). Conclusion Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

Ossicular Discontinuity and Exostoses in Proteus Syndrome: A Case Report

2005 ◽  
Vol 114 (3) ◽  
pp. 242-246
Author(s):  
Joni K. Doherty ◽  
Dennis R. Maceri
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Typical Feature ◽  
Proteus Syndrome ◽  
Frequency Range ◽  
Pure Tone Average ◽  
Ossicular Chain Reconstruction ◽  
Conductive Hearing

Proteus syndrome (PS) is a rare hamartomatous disorder characterized by mosaic overgrowth of multiple tissues that manifests early in life and is progressive. The presence of unilateral external auditory canal exostoses in a patient who is not a swimmer or surfer is suggestive of PS. However, hearing loss is not a typical feature. Here, we describe exostoses and ossicular discontinuity with conductive hearing loss in a patient with PS. The treatment consisted of canalplasty and ossicular chain reconstruction. A postoperative reduction was demonstrated in the patient's air-bone gap, from 21 dB to 13 dB for the pure tone average (four frequencies) and from 41 dB to 15 dB in the high-frequency range (6,000 to 8,000 Hz). Causes of ossicular discontinuity are discussed. Routine annual audiometric and otolaryngological evaluation should be considered in all patients with temporal bone inyolvement of PS.

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