scholarly journals Stapes Surgery in Far-Advanced Otosclerosis

2021 ◽  
pp. 014556132110130
Author(s):  
Moscillo Luca ◽  
Massimilla Eva Aurora ◽  
Mastella Americo ◽  
Nunziata Michele ◽  
Anna Donadio ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Pure Tone ◽  
Standardized Patients ◽  
Stapes Surgery ◽  
Postoperative Results ◽  
Hearing Results ◽  
Pure Tone Average ◽  
First Choice ◽  
Before And After

Introduction: Surgical treatment of patients with far-advanced otosclerosis (FAO) has not yet been standardized. Patients with FAO are the candidates for stapes surgery or cochlear implant (CI). Although many surgeons consider stapes surgery as the first choice, other authors prefer CI because of the excellent hearing results. Objective: The authors discuss their experience in the treatment of patients with FAO, potentially candidates for CI, who underwent stapedotomy. Materials and Methods: Eleven adult patients with FAO underwent stapedotomy from 2006 to 2016. Pure-tone average (PTA) between 0.5-1-2-3 kHz and speech perception test with hearing aids were determined before and after stapedotomy. Results: The results show a statistically significant improvement in air condition threshold (PTA) and satisfactory results with regard to speech recognition in 9 (81.8%) cases. Postoperative results are not influenced by the type of stapedotomy prosthesis employed and do not change during follow-up (3 years). Conclusions: The authors suggest first performing stapes surgery in patients with FAO and reserving CI in case of failure.

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.

Role of stapes surgery in improving hearing loss caused by otosclerosis

2006 ◽  
Vol 121 (5) ◽  
pp. 438-443 ◽  
Author(s):  
M R Marchese ◽  
G Paludetti ◽  
E De Corso ◽  
F Cianfrone
Keyword(s):  
Pure Tone ◽  
Functional Results ◽  
Oval Window ◽  
Stapes Surgery ◽  
Hearing Results ◽  
Pure Tone Average ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Operative Assessment

The aim of our study was to evaluate the functional results of stapes surgery and to compare the effectiveness of small fenestra stapedotomy with that of total stapedectomy in improving hearing in patients affected by otosclerosis.Three hundred and fifty-seven consecutive ears, in 265 patients affected by otosclerosis, underwent surgery. All cases underwent either primary small fenestra stapedotomy (group A, 196/357, 54.91 per cent) or stapedectomy (group B, 161/357, 45.09 per cent). After surgery, 256/357 (71.71 per cent) cases showed a 0–20 dB gap. There were no significant differences in hearing results between the two groups at either early or late post-operative assessment. The mean post-operative pure tone average and air–bone gap results were slightly greater for group B than for group A, at both early and late post-operative assessments, but these differences were not statistically significant. Therefore, in group A, the mean pure tone average at 4 kHz significantly improved, from 56.60 to 47.66 dB at early post-operative assessment and to 52.98 dB at late post-operative assessment.Our study suggests that the technique of microtomy of the oval window is able to improve hearing results especially at high frequencies.

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>

Middle Fossa Approach for Resection of Vestibular Schwannomas: A Decade of Experience

2018 ◽  
Vol 16 (2) ◽  
pp. 147-158 ◽  
Author(s):  
Jennifer A Kosty ◽  
Shawn M Stevens ◽  
Yair M Gozal ◽  
Vincent A DiNapoli ◽  
Smruti K Patel ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Tumor Size ◽  
Pure Tone ◽  
Vestibular Schwannomas ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Pure Tone Average ◽  
Class A ◽  
The Mean

AbstractBACKGROUNDThe middle cranial fossa (MCF) approach is a challenging surgical technique for the resection of small and intermediate sized, primarily intracanalicular, vestibular schwannomas (VS), with the goal of hearing preservation (HP).OBJECTIVETo describe a decade-long, single institutional experience with the MCF approach for resection of VS.METHODSThis is a retrospective cohort study of 63 patients who underwent the MCF approach for resection of VS from 2006 to 2016. Audiometric data included pure-tone average (PTA), low-tone pure-tone average (LtPTA), word recognition score, and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) hearing classification at presentation and follow-up. Patients with postoperative serviceable (AAO-HNS class A-B) and/or useful (AAO-HNS class A-C) hearing were compared to those without HP. Facial nerve function was assessed using the House–Brackmann scale.RESULTSThe mean age and duration of follow-up were 50 ± 13 yr and 21 ± 21 mo, respectively. The mean tumor size was 10 ± 4 mm. The serviceable and usable HP rates were 54% and 50%, respectively. Some residual hearing was preserved in 71% of patients. Large tumor size (P = .05), volume (P = .03), and extrameatal tumor extension (P = .03) were associated with poor audiometric outcomes. The presence of a fundal fluid cap (P = .01) was a favorable finding. At definitive testing, LtPTA was significantly better preserved than traditional PTA (P = .01). Facial nerve outcomes, tumor control rates, and durability of audiometric outcomes were excellent. 47% of patients pursued aural rehabilitation.CONCLUSIONIn our series, the MCF approach for VS provided excellent rates of tumor and facial nerve function, with durable serviceable HP.

Auditory function in early syphilis A follow up study

1984 ◽  
Vol 98 (6) ◽  
pp. 567-572 ◽  
Author(s):  
Ulf Rosenhall Gun-Briti Löwhagen ◽  
Gösta Roupe
Keyword(s):  
Hearing Loss ◽  
Auditory System ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Auditory Brainstem ◽  
Vascular Involvement ◽  
Auditory Function ◽  
Follow Up Study ◽  
Before And After

Abstract Twenty-six patients with secondary or early latent sypilis were examined by auditory brainstem reponse (ABR) audiometry and by pure tone audiometry before and after treatment. Normalization was registered in four of seven patients with pathological ABR before treatment, while in three patients the ABR abnormalities remained after treatment. Thirteen patients exhibited a sensorineural hearing-loss before treatment. In two patients this hearing-loss improved after treatment and a syphilitic etiology seems plausible. The reversible lesions in the auditory system may be related to asymptomatic syphilitic meningitis. Permanent ABR abnormalities might reflect syphilitic vascular involvement in the brainstem.

scholarly journals Longitudinal associations between hearing aid usage and cognition in community-dwelling Japanese older adults with moderate hearing loss

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258520
Author(s):  
Saiko Sugiura ◽  
Yukiko Nishita ◽  
Yasue Uchida ◽  
Mariko Shimono ◽  
Hirokazu Suzuki ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Function ◽  
Pure Tone ◽  
Community Dwelling ◽  
Pure Tone Average ◽  
Time Interaction ◽  
Picture Completion ◽  
Moderate Hearing Loss

We investigated the associations between hearing aids (HA) and the maintenance of cognitive function among community-dwelling older adults with moderate hearing loss. A total of 407 participants aged 60 years or older with moderate hearing loss were recruited from the National Institute for Longevity Sciences, Longitudinal Study for Aging (NILS-LSA). Moderate hearing loss was defined as a pure-tone average of 40–69 dB at 500, 1000, 2000, and 4000 Hz of the better ear, according to the definition proposed by the Japan Audiological Society. Cognitive function was evaluated using the four subtests of the Japanese version of the Wechsler Adult Intelligence Scale-Revised Short Forms (WAIS-R-SF): Information, Similarities, Picture completion, and Digit Symbol Substitution (DSST). A longitudinal analysis of 1192 observations with a mean follow-up period of 4.5 ± 3.9 years was performed. The HA use rate at any time during the follow-up period was 31.4%, and HA users were significantly younger (t-test, p = 0.001), had worse hearing (p < .0001) and higher education (p = 0.001), participated more frequently in the survey (p < .0001), and were less depressed (χ2 test, p = 0.003) than the older adults not using HA. General linear mixed models consisted of the fixed effects of HA use, follow-up time, and an HA use × time interaction term adjusted for age and pure-tone average thresholds at baseline, sex, education, and other possible confounders. HA use showed significant main effects on the scores for Picture completion and DSST after adjustment; scores were better in the HA use group than in the no HA use group. The HA use × time interaction was significant for the Information score (p = 0.040). The model-predicted 12-year slope with centralizing age indicated that the no HA use group showed greater decline over time on Information scores than did HA use group. The slopes did not differ between HA users and non-users for the Similarities, Picture completion and DSST. In conclusion, HA use may have a protective effect on the decline in general knowledge in older adults with moderate hearing loss.

scholarly journals Hearing Aid Treatment in Patients with Mixed Hearing Loss. Part I: Expected Benefit and Limitations after Stapes Surgery

2020 ◽  
Vol 25 (3) ◽  
pp. 125-132
Author(s):  
Nina Wardenga ◽  
Victoria Diedrich ◽  
Bernd Waldmann ◽  
Thomas Lenarz ◽  
Hannes Maier
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Hearing Aids ◽  
State Of The Art ◽  
Treatment Success ◽  
Stapes Surgery ◽  
Pure Tone Average ◽  
Mixed Hearing Loss ◽  
Hearing Devices ◽  
Middle Ear Implants

Objective: The purpose of the present study was to determine the fraction of patients with mixed hearing loss who can or cannot expect benefit from power hearing aids (HAs) after stapes surgery. Design: The audiological outcome of 374 stapes surgeries was used to calculate the patients’ individual postoperative requirements in terms of gain and output of HAs. These requirements were compared to the available gain and output provided by state-of-the-art power HAs at 0.5, 1.0, 2.0, and 4.0 kHz. According to these comparisons, ears were divided into three groups. For G0, required gain and output lay within the corresponding technical limits of the HAs at all frequencies. In G1, one or both requirements could not be fulfilled at 1 frequency. G2 combined all ears where the requirements lay beyond the HA’s technical limitations at 2 or more frequencies. Results: Stapes surgery resulted in an improvement of air-bone gap (ABG) in 84.5% of the cases by 15.7 dB on average. Based on pure-tone average (0.5, 1.0, 2.0, 4.0 kHz), 40.6% of all cases showed an ABG ≤10 dB. 44.9% of all cases did no longer need a HA after stapes surgery. A power HA would fulfill both audiological criteria at all 4 frequencies in 81.6% of cases that needed a HA postoperatively. However, 18.4% would not be sufficiently treatable at 1 or more frequencies (15.0% in G1, 3.4% in G2). Conclusions: The present study identified a subset of patients with mixed hearing loss after stapes surgery that cannot be treated sufficiently with available power HAs. As the residual ABG is an important reason for this lack of treatment success, the advancement of alternative hearing devices that circumvent the middle ear, such as powerful active middle ear implants, is indicated.

scholarly journals Longitudinal Tracking of Sound Exposure and Hearing Aid Usage through Objective Data Logs

2018 ◽  
Vol 159 (1) ◽  
pp. 110-116
Author(s):  
John B. Doyle ◽  
Rohit R. Raghunathan ◽  
Ilana Cellum ◽  
Gen Li ◽  
Justin S. Golub
Keyword(s):  
Hearing Loss ◽  
Pure Tone ◽  
Hearing Aid ◽  
Medical Center ◽  
Academic Medical Center ◽  
Case Series ◽  
Data Logging ◽  
Sound Exposure ◽  
Pure Tone Average

Objective To use data-logging technology to objectively track and identify predictors of hearing aid (HA) usage and aided sound exposure. Study Design Case series with planned data collection. Setting Tertiary academic medical center. Subjects and Methods Individuals with HAs between 2007 and 2016 were included (N = 431; mean, 74.6 years; 95% CI, 73.1-76.0). Data-logging technology intrinsic to new-generation HAs was enabled to track usage and sound exposure. With multivariable linear regression, age, sex, number of audiology visits, duration of audiologic follow-up, pure tone average, and HA side were assessed as predictors of usage (hours/day) and aided sound exposure (dB-hours/day; ie, “dose” of sound per day). Results Mean follow-up was 319 days (95% CI, 277-360). Mean HA usage was 8.4 hours/day (95% CI, 8.0-8.8; N = 431). Mean aided sound exposure was 440 dB-hours/day (95% CI, 385-493; n = 110). HA use (β < 0.001, P = .45) and aided sound exposure (β = −0.006, P = .87) were both stable over time. HA usage was associated only with hearing loss level (pure tone average; β = 0.030, P = .04). Aided sound exposure was associated only with duration of audiologic follow-up (β = 0.100, P = .02). Conclusion While measurement of HA use has traditionally relied on subjective reporting, data logging offers an objective tool to longitudinally track HA use and sound exposure. We demonstrate the feasibility of using this potentially powerful research tool. Usage and sound exposure were stable among patients throughout the study period. Use was greater among subjects with greater hearing loss. Maximizing aided sound exposure might be possible through continued audiology follow-up visits.

The Speech Intelligibility Index and the Pure-Tone Average as Predictors of Lexical Ability in Children Fit With Hearing Aids

2012 ◽  
Vol 55 (3) ◽  
pp. 764-778 ◽  
Author(s):  
Derek J. Stiles ◽  
Ruth A. Bentler ◽  
Karla K. McGregor
Keyword(s):  
Hearing Aids ◽  
Speech Intelligibility ◽  
Pure Tone ◽  
Receptive Vocabulary ◽  
National Standards ◽  
Nonword Repetition ◽  
Pure Tone Average ◽  
Speech Intelligibility Index ◽  
Valid Estimate ◽  
Repeated Words

Purpose To determine whether a clinically obtainable measure of audibility, the aided Speech Intelligibility Index (SII; American National Standards Institute, 2007), is more sensitive than the pure-tone average (PTA) at predicting the lexical abilities of children who wear hearing aids (CHA). Method School-age CHA and age-matched children with normal hearing (CNH) repeated words and nonwords, learned novel words, and completed a standardized receptive vocabulary test. Analyses of covariance allowed comparison of the 2 groups. For CHA, regression analyses determined whether SII held predictive value over and beyond PTA. Results CHA demonstrated poorer performance than CNH on tests of word and nonword repetition and receptive vocabulary. Groups did not differ on word learning. Aided SII was a stronger predictor of word and nonword repetition and receptive vocabulary than PTA. After accounting for PTA, aided SII remained a significant predictor of nonword repetition and receptive vocabulary. Conclusions Despite wearing hearing aids, CHA performed more poorly on 3 of 4 lexical measures. Individual differences among CHA were predicted by aided SII. Unlike PTA, aided SII incorporates hearing aid amplification characteristics and speech-frequency weightings and may provide a more valid estimate of the child's access to and ability to learn from auditory input in real-world environments.

Sign in / Sign up

Export Citation Format

Share Document