S232 – Hearing Gain Following Stapes Surgery Maintained Long-term?

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P153-P153
Author(s):  
Purushotam Sen ◽  
Abir K Bhattacharyya

Objectives To analyse whether the hearing gain following stapes surgery is maintained long-term. Methods Databases (PubMed, EMBASE and MEDLINE) were searched systematically, with no limits on the year or language of publications, for observational studies on the long-term hearing results of stapedectomy (>10 years). References identified from pertinent reviews and articles were also retrieved. 2 reviewers independently searched the databases and selected the studies using pre-specified standardized criteria. These criteria included appropriate adjustments for confounding factors in the analyses. The terms used in the search included stapes surgery, stapedectomy, stapedotomy, long-term results, hearing gain. Data extraction and study quality evaluation were performed independently and results were pooled quantitatively. Results Early studies noted that both air conduction (AC) and bone conduction (BC) deteriorated with time, resulting in a return to baseline pre-operative hearing in the long-term. More recent studies showed that in the long term, the hearing gain was maintained by 75% of patients despite the advent of presbycusis. Surgeons' experience may play a more important role than the type of stapes surgery. On average, studies have shown that the air bone gap tended to increase at a rate of 0.9 dB per year. Conclusions Though some earlier studies were equivocal, recent studies indicate that most stapes surgery patients maintain good hearing long-term, even though there is a gradual decline in the air conduction and bone conduction thresholds. Longitudinal studies are required to better understand this subject.

2019 ◽  
Vol 133 (8) ◽  
pp. 658-661 ◽  
Author(s):  
B Demir ◽  
A Binnetoglu ◽  
A Sahin ◽  
U Derinsu ◽  
Ç Batman

AbstractObjectiveThis study aimed to evaluate the long-term results of ossiculoplasty using bone cement.MethodForty patients (24 females and 16 males; mean age: 34.1 ± 11.8 years; range, 9–54 years) with chronic otitis media with perforation but without cholesteatoma who had undergone incudostapedial rebridging ossiculoplasty using bone cement were evaluated retrospectively. Pre-operative and post-operative audiograms were evaluated. Bone conduction, air conduction and air–bone gaps were calculated according to international guidelines.ResultsThere was a mean reduction in pre-operative and post-operative air conduction (12.30 ± 11.98 dB), and this result was significant (p = 0.0001). There was a mean reduction in pre-operative and post-operative bone conduction (4.30 ± 6.69 dB), and this result was significant (p < 0.0001). The pre-operative air–bone gap was 27.65 dB and decreased to 19.65 dB during follow-up (p = 0.0001). No adverse reactions or complications were observed.ConclusionBone cement is reliable for the repair of incudostapedial-joint defects.


1992 ◽  
Vol 106 (11) ◽  
pp. 971-973 ◽  
Author(s):  
Eero Vartiainen ◽  
Juhani Nuutinen ◽  
Jukka Virtaniemi

AbstractResults of 45 re-operations for persistent or recurrent conductive deafness after primary stapes surgery were studied. The mean follow-up period after the revision surgery was 7.6 years. Long-term hearing results were found to be disappointing, air-bone gap to within 10 dB was achieved in only 46 per cent of the patients. Mean hearing levels improved by 11 dB or more in 73 per cent. Outcome of surgery was dependent on the surgical pathology, the best hearing results were obtained in cases with re-fixation after stapes mobilization operation. Sensorineural hearing loss as a result of surgical trauma to the inner ear occurred in revision surgery more frequently than in primary operations, cases with regrowth of otosclerotic bone to the oval window after stapedectomy having the greatest risk of labyrinthine trauma.


2010 ◽  
Vol 15 (Number 2) ◽  
pp. 9-14
Author(s):  
Md. A Sikder ◽  
Md. Daulatuzzaman ◽  
SM K A Mazumder ◽  
N U Khan ◽  
Md. S Alam

The aim of this study was to assess hearing improvement after myringoplasty within ten weeks following surgery. The study population consisted of 30 patients who were suffering from CSOM-77". Pre-operative and post-operative eraminations of the patients were conducted clinically as well as audiologically. Pre-and post-operative air-bone (A-B) gap were calculated by raking the averages of bone conduction and air conduction at the frequencies of 300. 1000 and 2000 Hz. Myringoplasty was done with underlay technique under general anaesthesia by postaural approach. Temporal 'muck fascia was used as grafting material for reconstruction of the tympanic membrane. Pre-operatively, air-bone gap of 30 db or more was observed in 39 (78%) patients whereas post-operatively A-B gap of 30 db or mare was observed in only one patient. Using hearings gain exceeding 15 dB as the criterion. 39 (78%) patients had their hearing gain exceeding 15 dB. Using post-operative A-B gap within 20 dB as the criterion. 42 (84%) patients had their A-8 gap within 20 dB. Myringoplasty is a beneficial procedure for hearing improvement. Using the proportion of patients with a post-operative A-B gap of 30 dB as the criterion, in this study. 98% of patients achieved their A-B gap closer within 30 dB. Using hearing gain exceeding 15 dB as the criterion, 78% patient had their hearing gain exceeding 15 dB.


2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Chao-Yin Kuo ◽  
Bor-Rong Huang ◽  
Hsin-Chien Chen ◽  
Cheng-Ping Shih ◽  
Wei-Kang Chang ◽  
...  

The aim of this study was to retrospectively review the long-term hearing results and the impact of mastoid exclusion/obliteration in patients with cholesteatoma (102 ears) who underwent retrograde tympanomastoidectomy and in whom bone chips/paté were applied as the sole materials during the procedure. In 79 ears, this was combined with ossiculoplasty in a single-stage procedure. In >71% of ears, the results of audiometric testing were monitored for more than 2 years. The results suggested there was a significant gain in hearing following surgery, with respect to the postoperative change in both air-conduction thresholds and air-bone gaps (P<0.001). Linear regression analyses of pure-tone averages at different frequencies, before and after surgery, demonstrated that patients benefitted from a postoperative hearing gain at low and middle frequencies, but their hearing often deteriorated at frequencies of 8000 Hz. As for the impact of the type of tympanoplasty on hearing outcomes, type III-interposition markedly increased hearing gain. The overall rate of postoperative adverse events was 8.8%. We conclude that reconstruction of the ear canal and mastoid via mastoid exclusion/obliteration using bone chips/paté can be considered as an alternative procedure following retrograde mastoidectomy. It gives excellent surgical results and has fewer postoperative adverse events.


2020 ◽  
Vol 25 (1) ◽  
pp. 54-59
Author(s):  
Sutanu Kumar Mondal ◽  
Ashim Kumar Biswas ◽  
Md Mahmudul Huq ◽  
Md Hasan Ali ◽  
Md Kamruzzaman ◽  
...  

Objectives: To assess hearing gain after successful myringoplasty in relation to the size of tympanic membrane perforation. Methods: This cross-sectional study was done in the department of otolaryngology and head neck surgery, BSMMU, Sahbag, Dhaka during the period of January 2009 to December 2010.A total of 60 patients were under went myringoplasty operation after taking detailed history, clinical examination and investigation. Preoperative and postoperative hearing assessment was done. Analysed data presented by various tables, graphics and figures. Results: In case of small size perforation preoperative mean bone conduction threshold was 7.66 dB, mean air conduction threshold was 34.14 dB and mean air bone gap was 26.48 dB. In case of medium size perforation preoperative mean bone conduction threshold was 9.61 dB, mean air conduction threshold was 44.48 dB. Mean air bone gap was 34.87 dB. In case of large size perforation preoperative mean bone conduction threshold was 13.12 dB, mean air conduction threshold was 59 dB, and mean air bone gap was 45.88 dB. Hearing loss increases with increasing size of perforation. Ahmed and Rahim (1979) showed in the study that hearing loss increases with increasing the size of the perforation which was relevant in the study. After myringoplasty post-operative mean air bone gap was 21.24 dB in small size, 21.74 dB in medium sized and 24 dB in large size. From the record improvement of mean air bone gap or hearing gain was 5.24 dB in small size perforation respectively. The different of air bone gap closure between small and medium size perforation was statistically significant by unpaired’ test. Conclusion: Hearing gain after myringoplasty is better in large size perforation. Bangladesh J Otorhinolaryngol; April 2019; 25(1): 54-59


1973 ◽  
Vol 82 (4) ◽  
pp. 538-546 ◽  
Author(s):  
D. Thane R. Cody ◽  
William F. Taylor

Long-term results after 878 tympanoplasties using five different methods of repair were analyzed. The five groups were as follows: canal skin and fascia, single fascia, double fascia, canal skin, and canal skin and homograft tympanic membrane. Ten percent of the graft failures occurred 18 months or longer after operation. The highest percentage of graft takes (88%) and satisfactory hearing improvement (socially adequate level 87%, air-bone gap closure to within 15 dB 76%) and the lowest incidence of depression in cochlear reserve (0.7%) was in the double fascia group. Overall hearing results achieved in the 878 tympanoplasties were poorer than anticipated. Differences in results in the five groups, although occasionally large, were not statistically significant. Differences in the percentage of successful graft takes in ears that had no active disease as compared with ears that had active disease and in primary operations as compared with revision operations were not statistically significant. Complications encountered were common and varied.


1996 ◽  
Vol 110 (4) ◽  
pp. 315-318 ◽  
Author(s):  
Eero Vartiainen ◽  
Jukka Vartiainen

AbstractThe effect of aerobic bacteriology on the clinical presentation, complications of the disease and long-term results of surgical treatment was assessed in a cohort of 368 patients with chronic suppurative otitis media. Bacteriological findings showed no significant difference between child and adult patients. Staphylococcus aureus was isolated in cholesteatoma ears more frequently than Pseudomonas aeruginosa, in chronic ears without cholesteatoma the situation was reversed. Bacteriological findings had no significant effect on the incidence of complications caused by the disease. Failures after surgical treatment were most common in Pseudomonas ears. The bacteriology had no significant effect on pre-operative hearing levels nor postoperative hearing results. It was concluded that, in order to improve results of chronic ear sugery, more attention should be paid to pre-operative conservative treatment of chronically discharging ears, especially those infected by P. aeruginosa.


2006 ◽  
Vol 121 (4) ◽  
pp. 324-328 ◽  
Author(s):  
E De Corso ◽  
M R Marchese ◽  
B Sergi ◽  
M Rigante ◽  
G Paludetti

The aim of this study was to evaluate the hearing results of ossiculoplasty in canal wall down tympanoplasty in one stage middle-ear cholesteatoma surgery.We carried out a retrospective review of a consecutive series of 142 cases which had undergone type two or three canal wall down tympanoplasty with ossicular reconstruction, between January 1995 and December 2002, due to chronic otitis media with cholesteatoma.Pre-operative audiometric testing revealed a mean air conduction pure tone average (PTA) of 50.97 dB and a mean bone conduction PTA of 22.14 dB. The mean post-operative result for air conduction PTA was 37.62 and for bone conduction PTA was 23.37 dB. The mean pre- and post-operative air–bone gaps (ABGs) were 28.83 and 13.94 dB, respectively, with a gain of 14.89 dB. Almost 62.67 per cent of patients closed their ABGs to within 20 dB.Our functional results are comparable with those of other authors. In the present study, we show that hearing improvement is possible following cholesteatoma surgery with canal wall down tympanoplasty and ossicular chain reconstruction.


1988 ◽  
Vol 102 (2) ◽  
pp. 136-137 ◽  
Author(s):  
S. B. Ogale ◽  
C. Desouza ◽  
J. Sheode ◽  
K. L. Shah

AbstractOur pilot study reports twenty-six cases of resolved chronic otitis media in which the human, cadaveric styloid process was used as an ossicular graft material. A maximum follow-up of one year is presented in this paper. There was no extrusion or rejection of the styloid processes. Hearing improvement with a closure of the air-bone gap to within 10–15 dB. of the pre-operative bone conduction was found in most cases. So far the styloid process has proved to be an ideal ossicular graft though the long-term results are yet to be seen.


1992 ◽  
Vol 106 (8) ◽  
pp. 688-691 ◽  
Author(s):  
T. R. Kapur ◽  
S. Jayaramchandran

AbstractThe long-term results of 63 total ossicular chain reconstructions using autografts is presented. The follow-up period ranged from 18 months to 18 years with an average of 8.5 years. The primary aims of the study were firstly to assess the long-term success rate and to find out if there were any hitherto unknown causes of bone graft failure. In the event, it was found that the recently described anatomical variation of the oval window viz., the deep oval window, was the prime cause of failure in 32 per cent of unsuccessful cases. Some measures to help to mitigate this problem, are suggested. The result were assessed on the basis of:1. A minimum gain of 20 dB HL in air conduction (Technical success). The success rate was 55.5 per cent.2. Patients benefited using Smyth and Patterson's criteria in conjunction with the Glasgow Benefit Plot; 54 percent of the patients benefited significantly.


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