Long-term outcomes of ossiculoplasty using bone cement

2019 ◽  
Vol 133 (8) ◽  
pp. 658-661 ◽  
Author(s):  
B Demir ◽  
A Binnetoglu ◽  
A Sahin ◽  
U Derinsu ◽  
Ç Batman
Keyword(s):  
Bone Cement ◽  
Adverse Reactions ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Incudostapedial Joint ◽  
Air Conduction

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.

The styloid process in ossicular chain reconstruction

1988 ◽  
Vol 102 (2) ◽  
pp. 136-137 ◽  
Author(s):  
S. B. Ogale ◽  
C. Desouza ◽  
J. Sheode ◽  
K. L. Shah
Keyword(s):  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Styloid Process ◽  
Long Term Results ◽  
Graft Material ◽  
Ossicular Chain Reconstruction ◽  
One Year

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.

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.

scholarly journals Outcomes of Venous Malformation Sclerotherapy: A Review of Study Methodology and Long-Term Results

2017 ◽  
Vol 34 (03) ◽  
pp. 288-293 ◽  
Author(s):  
Sumera Ali ◽  
Sally Mitchell
Keyword(s):  
Venous Malformation ◽  
Long Term Results ◽  
International Studies ◽  
Venous Malformations ◽  
Long Term Outcomes ◽  
Relative Paucity ◽  
Study Methodology ◽  
Grading Scales

AbstractIt is very important that patients seeking sclerotherapy for the treatment of venous malformations are aware of the expected course of the therapy. They should be thoroughly counseled about the complications, the need for multiple sessions of therapy, and also about the expected clinical outcome. The aim of this review is to discuss the long-term outcomes of sclerotherapy for the treatment of venous malformation. Many studies have discussed their individual center's experiences and short-midterm results, but there is a relative paucity of data on long-term outcomes. We have reviewed the literature and also shared our experience of a large cohort of patients (n = 116) with a relatively longer follow-up period of more than 1 year. Venous malformations are very complex lesions and their treatment is quite variable depending on its extent and complexity. As a result, outcome studies vary considerably in the choice of sclerosant, study methodology, outcome assessment (clinical vs. imaging), and grading scales. This review also highlights this extreme heterogeneity in the literature of the sclerotherapy outcome and summarizes a few national and international studies for comparison.

scholarly journals Initial Gamma Knife Radiosurgery for Large or Documented Growth Asymptomatic Meningiomas: Long-Term Results From a 27-Year Experience

2020 ◽  
Vol 10 ◽  
Author(s):  
Junyi Fu ◽  
Lisha Wu ◽  
Chao Peng ◽  
Xin Yang ◽  
Hongji You ◽  
...  
Keyword(s):  
Median Time ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Long Term Results ◽  
Tumor Control ◽  
Long Term Outcomes ◽  
Radiological Progression ◽  
Design And Methods

ObjectiveThe aims of this study were to investigate the long-term outcomes of initial Gamma Knife radiosurgery (GKRS) for large (≥20 mm) or documented growth asymptomatic meningiomas.Design and MethodsThis was a single-center retrospective study. Fifty-nine patients with large (≥20 mm) or documented growth asymptomatic meningiomas undergoing initial GKRS were enrolled. The median age was 56 (range, 27–83) years. The median time of follow-up was 66.8 (range, 24.6–245.6) months, and the median tumor margin dose was 13.0 Gy (range, 11.6–22.0 Gy).ResultsTumors shrunk in 35 patients (59.3%) and remained stable in 23 (39.0%). One patient (1.7%) experienced radiological progression at 54 months after GKRS. The PFS was 100%, 97%, and 97% at 3, 5, and 10 years, respectively. Nine patients (15.3%) occurred new neurological symptoms or signs at a median time of 8.1 (range, 3.0–81.6) months. The symptom PFS was 90% and 78% at 5 and 10 years, respectively. Fifteen patients (25.4%) occurred peritumoral edema (PTE) at a median time of 7.2 (range, 2.0–81.6) months. One patient underwent surgical resection for severe PTE. In univariate and multivariate analysis, Only tumor size (≥25 mm) and maximum dose (≥34 Gy) were significantly associated with PTE [hazard ratio (HR)= 3.461, 95% confidence interval (CI)=1.157-10.356, p=0.026 and HR=3.067, 95% CI=1.068-8.809, P=0.037, respectively].ConclusionsIn this study, initial GKRS can provide a high tumor control rate as well as an acceptable rate of complications in large or documented growth asymptomatic meningiomas. GKRS may be an alternative initial treatment for asymptomatic meningiomas.

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

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P153-P153
Author(s):  
Purushotam Sen ◽  
Abir K Bhattacharyya
Keyword(s):  
Observational Studies ◽  
Quality Evaluation ◽  
Data Extraction ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Long Term Results ◽  
Hearing Results ◽  
Hearing Gain ◽  
Air Conduction

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.

Long-term results of total ossicular chain reconstruction using autografts

1992 ◽  
Vol 106 (8) ◽  
pp. 688-691 ◽  
Author(s):  
T. R. Kapur ◽  
S. Jayaramchandran
Keyword(s):  
Success Rate ◽  
Anatomical Variation ◽  
Ossicular Chain ◽  
Oval Window ◽  
Long Term Results ◽  
Ossicular Chain Reconstruction ◽  
Cause Of Failure ◽  
Air Conduction

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.

scholarly journals Management of colorectal anastomotic stricture with multidiameter balloon dilation: long-term results

2020 ◽  
Vol 24 (12) ◽  
pp. 1271-1276
Author(s):  
R.-H. Chan ◽  
S.-C. Lin ◽  
P.-C. Chen ◽  
W.-T. Lin ◽  
C.-H. Wu ◽  
...  
Keyword(s):  
Anastomotic Stricture ◽  
Balloon Dilation ◽  
Long Term Results ◽  
Endoscopic Dilation ◽  
Long Term Outcomes ◽  
Recurrence Rates ◽  
Aggressive Management ◽  
Anastomotic Strictures

Abstract Background Postoperative colorectal anastomotic strictures are quite common. As such, many techniques have been available to address such a problem, one of which is endoscopic dilation. The aim of the present study was to evaluate the long-term outcomes following endoscopic dilation using a multidiameter balloon. Methods A retrospective study was conducted on patients with postoperative anastomotic stenosis treated with endoscopic dilation using a multidiameter balloon at our institution, in January 2005–December 2019 were retrospectively reviewed, excluding those with tumor recurrence. Perioperative factors, complications, and recurrence rates were analyzed. Results There were 40 patients, (22 males and 18 females, mean age 64.6 ± 10.7 years, range 33–84 years). The median follow-up period was 56 months (interquartile range 22.5–99 months). Only 1 complication occurred, micro-perforation due to guided wire injury, which was managed conservatively. Five (12.5%) patients developed restenosis and underwent repeat balloon dilation. None of the five recurrences required more aggressive management, such as redo anastomosis. Conclusions Endoscopic multidiameter balloon dilation is a safe and effective method for treating benign colorectal anastomotic strictures.

Outcomes associated with secondary implant removal and arthrolysis in patients with a painful stiff shoulder after proximal humeral fracture fixation

2022 ◽  
Vol 104-B (1) ◽  
pp. 157-167
Author(s):  
Navnit S. Makaram ◽  
Ewan B. Goudie ◽  
C. Michael Robinson
Keyword(s):  
Proximal Humerus ◽  
Plate Fixation ◽  
Multivariable Analysis ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Patient Reported ◽  
Long Term Follow Up ◽  
Manual Occupation

Aims Open reduction and plate fixation (ORPF) for displaced proximal humerus fractures can achieve reliably good long-term outcomes. However, a minority of patients have persistent pain and stiffness after surgery and may benefit from open arthrolysis, subacromial decompression, and removal of metalwork (ADROM). The long-term results of ADROM remain unknown; we aimed to assess outcomes of patients undergoing this procedure for stiffness following ORPF, and assess predictors of poor outcome. Methods Between 1998 and 2018, 424 consecutive patients were treated with primary ORPF for proximal humerus fracture. ADROM was offered to symptomatic patients with a healed fracture at six months postoperatively. Patients were followed up retrospectively with demographic data, fracture characteristics, and complications recorded. Active range of motion (aROM), Oxford Shoulder Score (OSS), and EuroQol five-dimension three-level questionnaire (EQ-5D-3L) were recorded preoperatively and postoperatively. Results A total of 138 patients underwent ADROM; 111 patients were available for long-term follow-up at a mean of 10.9 years (range 1 to 20). Mean age was 50.8 years (18 to 75);79 (57.2%) were female. Mean time from primary ORPF to ADROM was 11.9 months (6 to 19). Five patients developed superficial wound infection; ten developed symptomatic osteonecrosis/post-traumatic arthrosis (ON/PTA); four underwent revision arthrolysis. Median OSS improved from 17 (interquartile range (IQR) 12.0 to 22.0) preoperatively to 40.0 (IQR 31.5 to 48.0) postoperatively, and 39.0 (IQR 31.5 to 46.5) at long-term follow-up (p < 0.001). Median EQ-5D-3L improved from 0.079 (IQR -0.057 to 0.215) to 0.691 (IQR 0.441 to 0.941) postoperatively, and 0.701 (IQR 0.570 to 0.832) at long-term follow-up (p < 0.001). We found that aROM improved in all planes (p < 0.001). Among the variables assessed on multivariable analysis, a manual occupation, worsening Charlson Comorbidity Index and increasing socioeconomic deprivation were most consistently predictive of worse patient-reported outcome scores. Patients who subsequently developed ON/PTA reported significantly worse one-year and late OSS. Conclusion ADROM in patients with persistent symptomatic stiffness following ORPF can achieve excellent short- and long-term outcomes. More deprived patients, those in a manual occupation, and those with worsening comorbidities have worse outcomes following ADROM. Cite this article: Bone Joint J 2022;104-B(1):157–167.

Long-term outcomes after pollicization: a mean 11-year follow-up study

2019 ◽  
Vol 45 (2) ◽  
pp. 173-180
Author(s):  
Camilla Hellevuo ◽  
Olli V. Leppänen ◽  
Susanne Kapanen ◽  
Simo K. Vilkki
Keyword(s):  
Functional Outcomes ◽  
Long Term Results ◽  
Long Term Outcomes ◽  
Level Of Evidence ◽  
Patients Satisfaction ◽  
Metacarpal Head ◽  
Follow Up Study ◽  
Age Related

This study evaluates the long-term results of pollicization for a congenitally absent or severely hypoplastic thumb. Twenty-nine patients with 34 pollicizations were divided to two groups: those with simple thumb hypoplasia (22 pollicizations) and those with radial longitudinal dysplasia (12 pollicizations). The patients were followed from 1.3 to 32 years, with a mean follow-up time of 11 years. The patients were examined clinically and radiologically, and they completed a questionnaire concerning satisfaction with appearance, function, and social interaction. The Percival score was also calculated. In both groups, grip and pinch strengths of the operated hands were inferior to the normative age-related values. Radiologically, flattening of the original metacarpal head was found in 20 out of the 34 operated hands. We found better patient satisfaction in the simple hypoplasia group than in the radial longitudinal dysplasia group. The functional outcomes and patients’ satisfaction did not correlate with the age of patients at operation. Level of evidence: IV

scholarly journals Surgical Aortic Mitral Curtain Replacement: Systematic Review and Metanalysis of Early and Long-Term Results

2021 ◽  
Vol 10 (14) ◽  
pp. 3163
Author(s):  
Ilaria Giambuzzi ◽  
Giorgia Bonalumi ◽  
Michele Di Mauro ◽  
Maurizio Roberto ◽  
Silvia Corona ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Pacemaker Implantation ◽  
Early Mortality ◽  
Long Term Results ◽  
High Complexity ◽  
Long Term Outcomes ◽  
Term Survival ◽  
Double Valve Replacement

The Commando procedure is challenging, and aims to replace the mitral valve, the aortic valve and the aortic mitral curtain, when the latter is severely affected by pathological processes (such as infective endocarditis or massive calcification). Given the high complexity, it is seldomly performed. We aim to review the literature on early (hospitalization and up to 30 days) and long-term (at least 3 years of follow-up) results. Bibliographical research was performed on PubMed and Cochrane with a dedicated string. Papers regarding double valve replacement or repair in the context of aortic mitral curtain disease were included. The metaprop function was used to assess early survival and complications (pacemaker implantation, stroke and bleeding). Nine papers (540 patients, median follow-up 41 (IQR 24.5–51.5) months) were included in the study. Pooled proportion of early mortality, stroke, pacemaker implant and REDO for bleeding were, respectively 16.2%, 7.8%, 25.1% and 13.1%. The long-term survival rate ranged from 50% to 92.2%. Freedom from re-intervention was as high as 90.9% when the endocarditis was not the first etiology and 78.6% in case of valvular infection (one author had 100%). Freedom from IE recurrences reached 85% at 10 years. Despite the high mortality, the rates of re-intervention and infective endocarditis recurrences following the Commando procedure are satisfactory and confirm the need for an aggressive strategy to improve long-term outcomes.

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