Audiometric Results after Stapedotomy Operations in Patients with Otosclerosis and Preoperative Small Air-Bone Gaps

2015 ◽  
Vol 20 (5) ◽  
pp. 330-336 ◽  
Author(s):  
Caroline Salmon ◽  
Sébastien Barriat ◽  
Laurent Demanez ◽  
David Magis ◽  
Philippe Lefebvre
Keyword(s):  
Retrospective Study ◽  
Co2 Laser ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Short Term ◽  
Air Conduction ◽  
Overall Risk

Objectives: The efficacy of stapedotomies performed on patients with small air-bone gaps (<25 dB) was compared with the efficacy of the operation in patients who had otosclerosis with high air-bone gaps (≥25 dB). Methods: This retrospective study evaluates the short-term postoperative air and bone conduction thresholds and air-bone gaps after 182 CO2 laser stapedotomies. Results: A significantly smaller air-bone gap and lower air conduction thresholds after surgery were observed in the group of patients who underwent surgery with preoperative air-bone gaps of less than 25 dB. Bone conduction thresholds improve in the group with small air-bone gaps after surgery. Conclusions: The results after stapedotomies are good even if the preoperative air-bone gap is small and the overall risk of hearing deterioration due to stapes surgery remains low.

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.

Insertion of middle-ear Silastic sheeting during tympanoplasty: hearing outcomes

2010 ◽  
Vol 125 (5) ◽  
pp. 445-448 ◽  
Author(s):  
S M Elmorsy ◽  
H E Amer
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Chronic Inflammation ◽  
Middle Ear ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
One Year ◽  
Operative Findings ◽  
Hearing Outcomes ◽  
Air Conduction

AbstractObjective:To study the effect of Silastic®sheeting placed in the middle ear during tympanoplasty, including the effect on hearing.Design:Retrospective study.Background:Chronic inflammation of the middle ear is common. Surgical treatment sometimes results in middle-ear adhesions and hearing deterioration.Materials and methods:We selected 106 patients with chronic otitis media, middle-ear adhesions and intact ossicles, based on intra-operative findings. These patients underwent single-stage tympanoplasty either with or without insertion of Silastic sheeting. Audiometry was undertaken pre-operatively and one and 12 months post-operatively.Results:Patients who had undergone Silastic sheet insertion showed significantly better air conduction, bone conduction and air–bone gap averages one year post-operatively, compared with those who had not.

Stapes Surgery for Otosclerosis in Patients Presenting with Mixed Hearing Loss

2018 ◽  
Vol 23 (2) ◽  
pp. 82-88 ◽  
Author(s):  
Caroline Salmon ◽  
Sébastien Barriat ◽  
Philippe P. Lefebvre
Keyword(s):  
Quality Of Life ◽  
Hearing Loss ◽  
Word Recognition ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Auditory Function ◽  
Mixed Hearing Loss ◽  
Before And After ◽  
Air Conduction

Objectives: To evaluate the efficacy of stapes surgery in patients presenting with a preoperative mixed hearing loss (bone conduction thresholds ≥40 dB; 40 < air conduction thresholds (AC) < 85 dB). Patients and Methods: A total of 30 patients (32 ears) with mixed hearing loss who underwent primary stapedotomy were evaluated. Audiometric parameters were assessed before and after surgery. Contralateral thresholds were also reported. The need for a hearing aid (HA) after surgery and its impact on quality of life were also measured. Results: AC and word recognition at 40, 55 and 70 dB were significantly improved after stapes surgery. Only 16.6% of the patients needed an HA after surgery and reported being satisfied with the aid. Conclusion: Stapes surgery improved auditory function in patients with mixed hearing loss, allowing most patients to delay the need for an HA without worsening their quality of life.

Comparing intermediate-term hearing results of NiTiBOND and Nitinol prostheses in stapes surgery

2021 ◽  
pp. 1-4
Author(s):  
A Koukkoullis ◽  
I Gerlinger ◽  
A Kovács ◽  
Z Szakács ◽  
Z Piski ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Success ◽  
Bone Conduction ◽  
Hearing Results ◽  
Bone Conduction Threshold ◽  
Hearing Thresholds ◽  
Group 3 ◽  
Group 2 ◽  
Air Conduction

Abstract Objective To statistically analyse the hearing thresholds of two cohorts undergoing stapedotomy for otosclerosis with two different prostheses. Method A retrospective study was conducted comparing NiTiBOND (n = 53) and Nitinol (n = 38) prostheses. Results Average follow-up duration was 4.1 years for NiTiBOND and 4.4 years for Nitinol prostheses. The post-operative air–bone gap was 10 dB or less, indicating clinical success. The p-values for differences between (1) pre- and post-operative values in the NiTiBOND group, (2) pre- and post-operative values in the Nitinol group, (3) pre-operative values and (4) post-operative values in the two groups were: air–bone gap – p < 0.001, p < 0.001, p = 0.631 and p = 0.647; four-frequency bone conduction threshold – p = 0.076, p = 0.129, p < 0.001 and p = 0.005; four-frequency air conduction threshold – p < 0.001, p < 0.001, p = 0.043 and p = 0.041; three-frequency (1, 2 and 4 kHz) bone conduction threshold pre-operatively – p = 0.639, p = 0.495, p = 0.001 and p = 0.01; and air conduction threshold at 4 kHz: – p < 0.001, p < 0.001, p = 0.03 and p = 0.058. Conclusion Post-operative audiological outcomes for NiTiBOND and Nitinol were comparable.

Stapedectomy Trends for the Resident

1988 ◽  
Vol 97 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Newton J. Coker ◽  
Newton O. Duncan ◽  
Geoffrey L. Wright ◽  
Herman A. Jenkins ◽  
Bobby R. Alford
Keyword(s):  
Prospective Study ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Training Experience ◽  
Faculty Supervision ◽  
A Prospective Study ◽  
Air Conduction

The diminishing number of cases of otosclerosis limits the training experience in stapes surgery during residency. Results are suboptimal. Closure of the preoperative air conduction to within 10 dB of bone conduction was obtained in only 64 % of resident cases Efforts to maximize experience and improve results include closer faculty supervision, use of one stapedectomy technique, and a prospective study of individual residents' performance.

scholarly journals Is preoperative bone conduction shape a prognostic factor in otosclerosis surgery?

2021 ◽  
Author(s):  
Rémi HERVOCHON ◽  
ALIX VAUTERIN ◽  
Ghizlene Lahlou ◽  
Yann Nguyen ◽  
Georges Lamas ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Significant Difference ◽  
Impaired Group ◽  
Group 2 ◽  
Average Bone ◽  
Air Conduction ◽  
Better Than ◽  
Group 1

1. We focused on 175 patients operated on for otosclerosis. There were 89 in group 1 (preoperative 4000 Hz BC threshold better than 2000 Hz) and 86 in group 2 (preoperative 2000 Hz BC threshold better than 4000 Hz). 2. Preoperatively, there was no significant difference in terms of average bone conduction (BC) thresholds, average air conduction (AC) thresholds and air-bone gap (ABG) between the two groups. 3. Three months and 1 year after surgery, group 1 had better audiometric outcomes than group 2 in terms of average AC and BC thresholds and ABG. 4. Postoperative BC gain was better in group 1 than group 2, particularly at 500 Hz, 1000 Hz and 2000 Hz. 5. When the 4000 Hz BC threshold was preoperatively impaired (group 2), it was not worsened after stapes surgery. This was not the case in group 1.

Office-Based Stapes Surgery

2019 ◽  
Vol 161 (6) ◽  
pp. 1018-1026 ◽  
Author(s):  
Béatrice Voizard ◽  
Anastasios Maniakas ◽  
Issam Saliba
Keyword(s):  
Operating Room ◽  
Pure Tone ◽  
Care Center ◽  
Tertiary Care ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Complication Rates ◽  
Pure Tone Average ◽  
Air Conduction

Objective The objective of this study was to provide a proof of concept and to assess the success and safety of stapes surgery for otosclerosis under local anesthesia in an office-based setting (OBS) as compared with a hospital operating room setting (ORS). Study Design Retrospective cohort study. Setting We reviewed all patients who underwent stapes surgery by the same surgeon from October 2014 to January 2017 at our tertiary care center (ORS, n = 36, 52%) and in an OBS (n = 33, 48%). Subjects and Methods The surgical technique was identical in both groups. All patients had a temporal bone computed tomography scan and audiogram within the 6 months prior to surgery. Air-bone gaps (ABGs), bone conduction, and air conduction pure tone average values were calculated. Preoperative results for pure tone average, bone conduction, ABG, and word recognition scores were compared with early (4 months) and late (12 months) follow-up audiograms. Intra- and postoperative complications were compared. Results Both groups were comparable in terms of demographic characteristics and severity of disease. The mean 1-year postoperative ABG was 5.66 dB (95% CI = 4.42-6.90) in the ORS group and 6.30 dB (95% CI = 4.50-8.10) in the OBS group ( P = .55). ABG improved by 24.27 dB (95% CI = 21.40-27.13) in the ORS group and 23.15 dB (95% CI = 18.45-27.85) in the OBS group ( P = .68). Complication rates did not differ, although this study remains underpowered. Conclusions In this small group of patients, the success of stapes surgery performed in an OBS and its complications were comparable to those of an ORS, thus providing an alternative to patients on long operating room waiting lists.

scholarly journals Short-Term Audiological Results of Diode Laser in Comparison with Manual Perforation in Stapes Surgery

2017 ◽  
Vol 22 (02) ◽  
pp. 119-124
Author(s):  
Rogerio Hamerschmidt ◽  
Stephanie Saab ◽  
Bettina Carvalho ◽  
Carolina Carmo
Keyword(s):  
Diode Laser ◽  
Randomized Clinical Trials ◽  
Bone Conduction ◽  
Functional Results ◽  
Conventional Technique ◽  
Stapes Surgery ◽  
Functional Improvement ◽  
Short Term ◽  
Significant Difference ◽  
Safe Technique

Introduction Diode laser is a new alternative in stapes surgery for otosclerosis. The present study is the first to compare the short-term results of the surgery performed using diode laser to those obtained through the conventional fenestration technique. Objective To use audiometry to establish a comparative analysis between the functional results obtained through surgery for otosclerosis using diode laser and the conventional technique. Method Audiometric evaluation of 12 patients submitted to stapes surgery for otosclerosis, using diode laser or conventional fenestration by needle and drills, between 2014 and 2015. Each group was composed of 6 patients. Pre and post-operative measures were compared for three months in both groups. The speech recognition threshold, the air and bone conduction threshold, as well as the gap between them at 500 Hz, 1 KHz, 2 KHz and 4 KHz were measured. Results Significant difference in bone conduction and SRT was observed when compared post- and preoperative results in the diode group. However diode and conventional technique groups presented significant differences in air conduction and air-bone gap, suggesting that both can provide functional improvement. Conclusion Laser stapedotomy is a safe technique with good results. Both laser surgery and the conventional technique have improved the hearing of patients with a discreet advantage for the diode laser. Further prospective and randomized clinical trials are required to disclose all possible benefits of the stapes surgery using diode laser.

S238 – Clip-fixation or Crimping? Results of 4 Stapes Prostheses

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P155-P155
Author(s):  
Daniel F A'Wengen
Keyword(s):  
Retrospective Study ◽  
Pure Tone ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
The Self ◽  
Speech Audiometry ◽  
Platinum Wire ◽  
Time Intervals ◽  
Different Types ◽  
Stapes Prosthesis

Objectives Learn about possible differences of results by 4 different stapes prostheses. Methods In this retrospective study, all 126 contiguous patients undergoing stapes surgery for otosclerosis are included. All surgeries were performed by 2 surgeons. 4 different types of stapes prostheses were used in separate time intervals. Starting with teflon-platinum wire prosthesis, to gold piston, to titanium piston, to the self-retaining titanium Clip-piston. Results Pre- and postoperative pure tone and speech audiograms are compared. The best results were achieved by the Clip-Piston. Improvement in PTA over other pistons was 4 dB with p= 0,027 (Mann-Whitney). Bone conduction levels were better by 2 dB. In speech audiometry intellegibility was better by 3 dB with p=0,024 (Mann-Whitney). Conclusions The tight self-fixation of the Clip-Piston to the long process of the incus achieved the best results in pure tone and even more so in speech audiometry. The reason might be due to reduced slippage of the stapes prosthesis at the attachment to the incus. As other studies have shown, tight fixation of a stapes prosthesis provides the best results. The Clip-Piston achieves this by its spring action and without the danger of heat and strangulation as by other stapes pistons.

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