Trends and Profiles in Stapes Surgery

Stapedectomy has become recognized as the procedure of choice in the surgical treatment of clinical otosclerosis. Based on results obtained in stapes surgery performed in 1977, profiles were established for hearing improvement, vertigo, tinnitus, chorda tympani injury and temporary threshold shift of high tones. Tympanometric and stapedial muscle reflex tests in cases of proved clinical otosclerosis also are discussed. The profiles indicate that stapedectomy performed on a regular basis and under ideal conditions is highly successful for the improvement of hearing. The incidence and probable causes of complications are presented and discussed. This study reveals, however, that the number of new patients with otosclerosis has decreased steadily since its peak in 1964. Should the number of surgical cases continue to diminish, it may be impossible for the practicing otologist to maintain sufficient expertise for the performance of an occasional stapedectomy. Also, it may become impossible to provide sufficient experience in otosclerosis surgery for all trainees in otolaryngology.

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Decay of Temporary Threshold Shift in Noise

Journal of Speech and Hearing Research ◽

10.1044/jshr.1602.267 ◽

1973 ◽

Vol 16 (2) ◽

pp. 267-270 ◽

Cited By ~ 5

Author(s):

John H. Mills ◽

Seija A. Talo ◽

Gloria S. Gordon

Keyword(s):

Sound Field ◽

Threshold Shift ◽

Temporary Threshold Shift ◽

Octave Band ◽

Band Noise ◽

Lower Asymptote

Groups of monaural chinchillas trained in behavioral audiometry were exposed in a diffuse sound field to an octave-band noise centered at 4.0 k Hz. The growth of temporary threshold shift (TTS) at 5.7 k Hz from zero to an asymptote (TTS ∞ ) required about 24 hours, and the growth of TTS at 5.7 k Hz from an asymptote to a higher asymptote, about 12–24 hours. TTS ∞ can be described by the equation TTS ∞ = 1.6(SPL-A) where A = 47. These results are consistent with those previously reported in this journal by Carder and Miller and Mills and Talo. Whereas the decay of TTS ∞ to zero required about three days, the decay of TTS ∞ to a lower TTS ∞ required about three to seven days. The decay of TTS ∞ in noise, therefore, appears to require slightly more time than the decay of TTS ∞ in the quiet. However, for a given level of noise, the magnitude of TTS ∞ is the same regardless of whether the TTS asymptote is approached from zero, from a lower asymptote, or from a higher asymptote.

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Damage Risk: An Evaluation of the Effects of Exposure to 85 versus 90 dBA of Noise

Journal of Speech and Hearing Research ◽

10.1044/jshr.1902.216 ◽

1976 ◽

Vol 19 (2) ◽

pp. 216-224 ◽

Cited By ~ 3

Author(s):

James T. Yates ◽

Jerry D. Ramsey ◽

Jay W. Holland

Keyword(s):

White Noise ◽

Statistical Difference ◽

Noise Exposure ◽

Threshold Shift ◽

Temporary Threshold Shift ◽

Noise Levels ◽

Potential Damage ◽

Full Day ◽

Damage Risk

The purpose of this study was to compare the damage risk of 85 and 90 dBA of white noise for equivalent full-day exposures. The damage risk of the two noise levels was determined by comparing the temporary threshold shift (TTS) of 12 subjects exposed to either 85 or 90 dBA of white noise for equivalent half- and full-day exposures. TTS was determined by comparing the pre- and postexposure binaural audiograms of each subject at 1, 2, 3, 4, 6, and 8 kHz. It was concluded that the potential damage risk, that is, hazardous effect, of 90 dBA is greater than 85 dBA of noise for equivalent full-day exposures. The statistical difference between the overall effects of equivalent exposures to 85 dBA as compared to 90 dBA of noise could not be traced to any one frequency. The damage risk of a full-day exposure to 85 dBA is equivalent to that of a half-day exposure to 90 dBA of noise. Within the limits of this study, TTS t was as effective as TTS 2 for estimating the damage risk of noise exposure.

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Acoustic-Reflex Dynamics for Pulsed Signals

Journal of Speech and Hearing Research ◽

10.1044/jshr.2102.295 ◽

1978 ◽

Vol 21 (2) ◽

pp. 295-308

Author(s):

Terry L. Wiley ◽

Raymond S. Karlovich

Keyword(s):

Duty Cycle ◽

Acoustic Impedance ◽

Normal Hearing ◽

Broadband Noise ◽

Threshold Shift ◽

Temporary Threshold Shift ◽

Acoustic Reflex ◽

Stapedius Muscle ◽

Duty Cycles

Contralateral acoustic-reflex measurements were taken for 10 normal-hearing subjects using a pulsed broadband noise as the reflex-activating signal. Acoustic impedance was measured at selected times during the on (response maximum) and off (response minimum) portions of the pulsed activator over a 2-min interval as a function of activator period and duty cycle. Major findings were that response maxima increased as a function of time for longer duty cycles and that response minima increased as a function of time for all duty cycles. It is hypothesized that these findings are attributable to the recovery characteristics of the stapedius muscle. An explanation of portions of the results from previous temporary threshold shift experiments on the basis of acoustic-reflex dynamics is proposed.

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On the Potential Deterioration in Hearing Due to Hearing Aid Usage

Journal of Speech Language and Hearing Research ◽

10.1044/jshr.2401.03 ◽

1981 ◽

Vol 24 (1) ◽

pp. 3-15 ◽

Cited By ~ 12

Author(s):

Larry E. Humes ◽

Fred H. Bess

Keyword(s):

Hearing Aid ◽

Threshold Shift ◽

Temporary Threshold Shift ◽

Hearing Sensitivity

This manuscript examines the issue of potential decline in hearing sensitivity due to hearing aid usage through an analysis of data obtained from the temporary threshold shift (TTS) paradigm. Following a critique of the traditional measures of TTS, the concept of integrated TTS (ITTS) is reviewed and data on hearing-aid-induced ITTS are presented. In addition, a series of equations relating permanent threshold shift (PTS) to a recently developed measure of noise dose (Dn) is derived and predictions for hearing-aid-induced PTS are made. Recommended gain settings established to protect the hearing of a person wearing a hearing aid from further decline following various durations of hearing aid usage are also provided.

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Free field threshold shift and temporary threshold shift reduction as measures of efficiency of ear protective devices.

PsycEXTRA Dataset ◽

10.1037/e454042004-001 ◽

1962 ◽

Author(s):

John L. Fletcher ◽

Michel Loeb

Keyword(s):

Free Field ◽

Threshold Shift ◽

Temporary Threshold Shift ◽

Protective Devices ◽

Ear Protective Devices

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Surgery of tympanosclerosis

The Journal of Laryngology & Otology ◽

10.1017/s0022215100138976 ◽

1997 ◽

Vol 111 (10) ◽

pp. 917-923 ◽

Cited By ~ 15

Author(s):

Syed Akhtar Kamal

Keyword(s):

Middle Ear ◽

Radical Surgery ◽

Stapes Surgery ◽

Hearing Improvement ◽

Short Term ◽

Two Stage ◽

Chi Square ◽

Physiological Basis

AbstractEighty-five cases with tympanosclerosis of the middle ear were treated surgically in this series from 1984 to 1995. Twelve of them were associated with cholesteatoma and had radical surgery performed. An attempt is made here to classify the tympanosclerosis on a patho-physiological basis. A planned two-stage procedure was performed in 36 cases after an interval of 18 months. The majority of patients had stapes surgery carried out by a two-stage procedure. One of the patients who did not have stapes surgery developed anacusis after 18 months post-operatively and in another patient recurrence was observed. Post-operative hearing improvement was found to be satisfactory in the short-term follow-up period of two to five years. The hearing improvement was analysed by using Chi-square value (x2) and also plotted in the Glasgow Benefit Plot.

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