THE EFFECT OF FENESTRATION OF THE OVAL WINDOW WITH VEIN GRAFT ON BONE CONDUCTION SENSITIVITY. (A Preliminary Study.)

1962 ◽  
Vol 72 (5) ◽  
pp. 608???623 ◽  
Author(s):  
JOHN S. ODESS ◽  
ROBERT E. ROACH
Keyword(s):  
Vein Graft ◽  
Bone Conduction ◽  
Oval Window ◽  
Preliminary Study

The Relation of Vibrator Surface Area and Static Application Force to the Vibrator-to-Head Coupling

1968 ◽  
Vol 11 (4) ◽  
pp. 805-810 ◽  
Author(s):  
E. R. Nilo
Keyword(s):  
Young Adult ◽  
Surface Area ◽  
Unit Area ◽  
Bone Conduction ◽  
Pressure Force ◽  
Adult Men ◽  
Surface Areas ◽  
History Of ◽  
Preliminary Study ◽  
Bone Conduction Hearing

Twelve young adult men with normal hearing and no history of ear disease took part in our study of the relation of vibrator surface area and static application force to the vibrator-to-head coupling. For vibrator surface areas of 1.125, 2.25, and 4.5 cm 2 coupled to the forehead under static forces of 150, 300, and 600 gm, monaural thresholds of bone-conduction hearing were determined at frequencies 250, 500, 1000, and 2000 Hz. With surface area constant, threshold improvement was frequency dependent. It decreased with increasing frequency until at 2000 Hz it was minimal. In contrast to this, with force constant, the influence of surface area was observed to begin at 2000 Hz. Preliminary study suggests this influence would extend to 4000 Hz. In view of the respective influence of application force and surface area to bone-conduction hearing, equating vibrator-to-head coupling on the basis of pressure (force per unit area), when there are two or more vibrators, may not represent an adequate control.

Histopathologic Findings following Surgical Procedures for Stapedial Ankylosis

1974 ◽  
Vol 83 (15_suppl) ◽  
pp. 3-31 ◽  
Author(s):  
George T. Nager ◽  
Bruce W. Jafek
Keyword(s):  
Vein Graft ◽  
Steel Wire ◽  
Oval Window ◽  
The Other ◽  
The Third ◽  
Teflon Piston ◽  
Surgical Methods ◽  
Temporal Bones ◽  
Perilymphatic Space ◽  
Histopathologic Findings

The histopathologic findings in the temporal bones of four patients with otosclerosis who had stapes operations, each according to a different surgical technique, are discussed. The four surgical methods employed included: 1) stapes interposition with a vein graft; 2) polyethylene strut over a vein graft; 3) fenestration of an obliterated oval window with a teflon piston; and 4) wire prosthesis over a remaining, shattered footplate. The first, third and fourth method provided a very satisfactory seal for the oval window. The polyethylene strut, on the other hand, protruded deeply into the vestibule and was about to perforate through the thinned vein graft. In the three remaining patients, the vestibular end of the prostheses was in fairly good alignment with the level or the oval window. Within the middle ear cavity all prostheses were invested in a thin coat of endothelial cells and connective tissue. Whereas the ring of the teflon piston prosthesis caused no bony atrophy, the stainless steel wire had induced a localized deossification at its site of attachment on the incus. The third and fourth cases disclosed some adhesions in the perilymphatic space around the oval window. All temporal bones revealed no injury to, or rupture of the utricle or saccule.

Effect of Oval Window Blockage on Bone Conduction in Cadaver Heads

2019 ◽  
Vol 40 (7) ◽  
pp. e668-e673
Author(s):  
Keguang Chen ◽  
Yongzheng Chen ◽  
Huiying Lyu ◽  
Dongming Yin ◽  
Lin Yang ◽  
...  
Keyword(s):  
Bone Conduction ◽  
Oval Window

Stapedectomy — A Long-Term Report

1982 ◽  
Vol 91 (5) ◽  
pp. 516-520 ◽  
Author(s):  
John J. Shea
Keyword(s):  
Vein Graft ◽  
Oval Window ◽  
Great Change ◽  
Autoimmune Response ◽  
Long Term Results ◽  
Hearing Gain ◽  
Teflon Piston

The long-term results with large fenestra stapedectomy with vein graft and Teflon piston are compared with results with the small fenestra stapedectomy with Teflon piston directly into the vestibule. There were 1,943 operations in the former group and 2,155 in the latter when compared in 1970. One hundred consecutive patients from the beginning of each group with follow-up to present were compared. Results were generally the same with no great change in 15 and 20 years as compared to those at 5 years. The complication of perilymph fistula was caused by creating an opening in the footplate much larger than the prosthesis and was eliminated by interposing a living oval window seal if the opening was much larger than the prosthesis and a flap of lining membrane from the promontory when it was not. Other factors that influence a good result are discussed, including the type and the diameter of the piston used, the type of living oval window seal and the method of attachment to the incus. The small fenestra operation was found to be superior to the large, not only for the hearing gain achieved, but the ease of performance and the freedom from complications due to migration of the prosthesis and/or the oval window seal. At present we have done about all that can be done for the conductive components. What remains is the sensorineural component which our studies indicate may be due to an autoimmune response.

Eighteen Years Experience in Stapedectomy

1978 ◽  
Vol 87 (3_suppl) ◽  
pp. 3-36 ◽  
Author(s):  
G. D. L. Smyth ◽  
T. H. Hassard
Keyword(s):  
Hearing Loss ◽  
Bone Conduction ◽  
Oval Window ◽  
Complication Rates ◽  
Similar Extent ◽  
Additional Information ◽  
Postoperative Findings ◽  
Standard Techniques ◽  
Cochlear Dysfunction

The postoperative findings in almost 800 stapedectomized ears were analyzed to evaluate the proposition that complication rates in stapedectomy were affected by the size of the footplate fenestration. It was concluded that small fenestra stapedectomy (diameter 0.4 mm) provided similar hearing gains to those achieved with standard techniques, that articulation problems occurred to a similar extent as with wire loop prostheses, and that there was a significantly lower incidence of a) fistula and b) immediate and delayed severe sensorineural hearing loss than with any other technique. There was also significantly less deterioration in bone conduction thresholds at 4 kHz after three years postoperatively. The incidence of severe immediate sensorineural loss in large fenestra stapedectomy (half or more of footplate removed) was significantly influenced by factors such as age, preoperative bone conduction thresholds and oval window pathology. A retrospective analysis provided no information which might predict oval window pathology. Additional information gained from the analysis indicated that with all types of stapedectomy, bone conduction did not deteriorate significantly more rapidly in the operated as compared to the unoperated ear, whereas in unoperated ears, deterioration in bone conduction was significantly greater in ears with mixed hearing losses than when the loss was purely sensorineural. It was concluded that small fenestra stapedectomy was currently the operation of choice because with it, the threat of cochlear dysfunction both immediately, and in the long term, was significantly less.

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