Persistent and recurrent conductive deafness following stapedotomy

2010 ◽  
Vol 125 (5) ◽  
pp. 460-466 ◽  
Author(s):  
G Thiel ◽  
R Mills
Keyword(s):  
Hearing Loss ◽  
Success Rate ◽  
Revision Surgery ◽  
Conductive Hearing Loss ◽  
Successful Outcome ◽  
Hearing Results ◽  
Gap Closure ◽  
Primary Procedure ◽  
Conductive Hearing

AbstractBackground:Stapedotomy produces the best hearing results of any otological operation. However, in a small number of cases the air–bone gap is not successfully closed, or conductive hearing loss recurs.Objective:To investigate the proportion of cases in the senior author's series which required revision surgery and to determine the medium to long term success rate of surgery, taking into account the results of revision surgery.Methods:Review of a series of 233 primary stapedotomy operations and 100 revision procedures carried out by one surgeon over a 20-year period.Results:Closure of the air–bone gap to within 10 dB was achieved in 80 per cent of cases following the primary procedure. Fifteen per cent of patients developed a recurrence of conductive hearing loss. When the results of revision surgery were taken into account, the proportion of ears with a mean air–bone gap of less than 10 dB was 86 per cent. However, of the patients undergoing revision surgery, air–bone gap closure to within 10 dB was only achieved in 52 per cent of cases.Conclusion:The best chance of obtaining a successful outcome in stapedotomy is to achieve this for the first procedure. However, revision surgery does increase the medium to long term success rate.

Long-term Compliance and Satisfaction With Percutaneous Bone Conduction Devices in Patients With Congenital Unilateral Conductive Hearing Loss

2015 ◽  
Vol 36 (5) ◽  
pp. 826-833 ◽  
Author(s):  
Rik C. Nelissen ◽  
Emmanuel A. M. Mylanus ◽  
Cor W. R. J. Cremers ◽  
Myrthe K. S. Hol ◽  
Ad F. M. Snik
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Bone Conduction ◽  
Conductive Hearing

scholarly journals Stapedotomy post-operative results and complications

2020 ◽  
Vol 6 (8) ◽  
pp. 1442
Author(s):  
Hanumant S. Giri ◽  
Ram C. Bishnoi ◽  
Pooja D. Nayak ◽  
Ninad S. Gaikwad
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Conductive Hearing Loss ◽  
Major Complication ◽  
Safe Procedure ◽  
Hearing Results ◽  
Post Surgery ◽  
Localized Disease ◽  
Conductive Hearing

<p class="abstract"><strong>Background:</strong> Otosclerosis is a hereditary localized disease of the bone derived from the otic capsule. It is characterized by alternating phases of bone formation and resorption and patient presents with conductive hearing loss. Treatment of otosclerosis can be of two kinds: hearing aids and surgery. Stapedectomy and stapedotomy are the two surgical procedures done for treatment of otosclerosis. Present study was conducted on 30 patients with otosclerosis who underwent stapedotomy to assess the hearing results post-surgery by serial Audiometric studies and to study the complications of stapedotomy surgery.</p><p class="abstract"><strong>Methods:</strong> This prospective observational study conducted on 30 patients of otosclerosis who fulfilled the inclusion and exclusion criteria.  </p><p class="abstract"><strong>Results:</strong> In this study of thirty cases of otosclerosis which were operated for small fenestra stapedotomy, we conclude that Hearing gain post-surgery was remarkable especially for patients with a pure conductive hearing loss. There was no deterioration in hearing after two years of follow-up. In our study on 30 patients we encountered minor complication in 4 patients (13.33%) and 1 major complication of profound sensorineural hearing loss 3.33%.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that stapedotomy is a relatively safe procedure with significant post-surgery hearing benefit.</p>

Fixation of the Anterior Mallear Ligament: Diagnosis and Consequences for Hearing Results in Stapes Surgery

2003 ◽  
Vol 112 (4) ◽  
pp. 348-355 ◽  
Author(s):  
Alexander Huber ◽  
Takuji Koike ◽  
Vel Nandapalan ◽  
Hiroshi Wada ◽  
Ugo Fisch
Keyword(s):  
Finite Element ◽  
Hearing Loss ◽  
Vibration Amplitude ◽  
Conductive Hearing Loss ◽  
Stapes Surgery ◽  
Hearing Results ◽  
Functional Failure ◽  
Human Temporal Bone ◽  
Manual Palpation ◽  
Conductive Hearing

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.

Consequences of Early Conductive Hearing Loss on Long-Term Binaural Processing

2017 ◽  
Vol 38 (5) ◽  
pp. 621-627 ◽  
Author(s):  
Kelley Graydon ◽  
Gary Rance ◽  
Richard Dowell ◽  
Bram Van Dun
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Binaural Processing ◽  
Conductive Hearing

Results of Revision Stapedectomy for Conductive Hearing Loss

1993 ◽  
Vol 109 (4) ◽  
pp. 742-747 ◽  
Author(s):  
Sanjay Prasad ◽  
Donald B. Kamerer
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Management Technique ◽  
Speech Discrimination ◽  
Hearing Results ◽  
Management Algorithm ◽  
Cause Of Failure ◽  
Conventional Manner ◽  
Conductive Hearing ◽  
Mean Time

Revision stapedectomy operations performed over a 13-year period (1977 to 1990) for a conductive hearing loss are reviewed in terms of intraoperative findings and hearing results. All operations were performed in a conventional manner without use of laser techniques. A management algorithm based on intraoperative findings is described. Results are compared with previously reported series. The 66 cases include 20 males and 46 females, ranging in age from 8 to 73 years. Mean time between original and revision stapedectomy was 12.5 years. Prostheses encountered at time of revision included wireloop (29), Robinson (18), polyethylene (14), other (3), and two were not found. The most common cause of failure was displacement of the prosthesis. Incus erosion was found in 48% of wireloops, 35% of polyethylene, and only 11% of the Robinson prostheses. Revision resulted in closure of the pure-tone average (PTA) air-bone gap to within 10 dB in 46% and to within 15 dB in 76%. Sensorineural hearing loss (> 10 dB) occurred in 5 cases (7.6%), and a decline in speech discrimination (> 10%) occurred in 17%. Three of four cases requiring drillout had gap closure to within 10 dB. Findings suggest that our management technique produces results comparable to other large reported series. Drillout at the time of revision can be recommended

scholarly journals Congenital Oval Window Aplasia: An Unusual Cause of Conductive Hearing Loss in an Adult

2016 ◽  
Vol 31 (1) ◽  
pp. 39-44
Author(s):  
Charlotte M. Chiong ◽  
Rachel T. Mercado-Evasco ◽  
Alessandra E. Chiong ◽  
Mary Ellen C. Perez ◽  
Franco Louie L. Abes ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Facial Nerve ◽  
Recent Literature ◽  
Conductive Hearing Loss ◽  
Oval Window ◽  
Surgical Approaches ◽  
Hearing Gain ◽  
Temporal Bone Ct ◽  
Conductive Hearing

Objective: To report a case of congenital oval window aplasia (COWA) in a Filipino adult presenting with  unilateral maximal conductive hearing loss and discuss the diagnostic considerations, pathophysiology and management. Methods:             Study Design:  Case report             Subjects: One (1)             Setting:  Tertiary Public Referral Center Results: Audiometric evaluation showed a maximal unilateral left conductive hearing loss. High resolution temporal bone CT showed absence of the oval window on the left along with facial and stapes abnormalities.  Exploratory tympanotomy showed an aberrant facial nerve, monopodal and abnormally located stapes and absent oval window.  Postoperative hearing gain achieved after a neo-oval window and Schuknecht piston wire prosthesis remained stable over two years. Conclusion: A congenital minor ear anomaly classified as Cremers Class 4a in which a congenital oval window aplasia was associated with an aberrant facial nerve anomaly and a monopodal stapes is reported. Recent literature supported the view that congenital oval window aplasia can in selected cases be amenable to various surgical approaches and a stable postoperative hearing gain is achievable in the long term. Keywords: oval window absence,  Cremers classification, congenital middle ear

Conductive hearing loss after surgical treatment of otosclerosis—long-term observations

2020 ◽  
Vol 74 (6) ◽  
pp. 1-5
Author(s):  
Witold Szyfter ◽  
Wojciech Gawęcki ◽  
Anna Bartochowska ◽  
Andrzej Balcerowiak ◽  
Marta Pietraszek ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Surgical Treatment ◽  
Medical Records ◽  
Conductive Hearing Loss ◽  
Good Method ◽  
Stapes Footplate ◽  
Conductive Hearing ◽  
Frequent Observation

Introduction: Surgical treatment of otosclerosis has been a commonly accepted method of treatment for many years. The improvement of hearing after surgery is sometimes even spectacular, and good results are obtained in many centres in over 90% of the entire operated population. However, in the years following the procedure, some patients develop permanent or progressive conductive hearing loss. The aim of the study is to present a group of patients with conductive hearing loss that appeared after the first otosclerosis surgery and to analyse the causes of its occurrence. Material and Methods: Retrospective analysis was performed on patients who were first operated on in the years 2000-2009. Their medical records were analysed by the end of 2019, which made it possible to obtain results on at least 10 years of postoperative follow-up. The group consisted of 1118 patients, aged 14-82, including 802 women and 316 men. Results: Reoperations due to conductive hearing loss were performed on 93 patients, who accounted for 8.3% of the originally operated patients. They were much more often performed on patients after stapedectomies (19.7%) than on patients after stapedotomy (5.5%). Intraoperatively, prosthesis displacement was found to be the most frequent observation (44.1%) and was often associated with erosion or necrosis of the long process of incus (28%). Less frequent reasons of hearing loss were: adhesions around the prosthesis (10.8%), too small hole in the stapes footplate (8.6%), too short prosthesis (8.6%), progression of otosclerosis (7.5%), too long prosthesis (6.4%), presence of a granuloma around the prosthesis (5.4 %), and displacement of incus (4.3%). Conclusions: Surgical treatment in otosclerosis is a widely accepted and good method. It allows improvement in hearing in the vast majority of patients treated in this way. Unfortunately, over the years, some patients develop conductive hearing loss again. Reoperation gives a chance to find the cause and improve hearing in most of these cases.

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