scholarly journals Two Cases of Stapedectomy with Ossiculoplasty in Stapes Fixation with Disrupted Ossicular Chain

2021 ◽  
Vol 32 (2) ◽  
pp. 143-148
Author(s):  
Hyeon Seok Oh ◽  
Byung Don Lee ◽  
Jae Joon Han
Keyword(s):  
Ossicular Chain ◽  
Stapes Fixation

Influence of ossicular chain malformation on the performance of round-window stimulation: A finite element approach

2019 ◽  
Vol 233 (5) ◽  
pp. 584-594 ◽  
Author(s):  
Houguang Liu ◽  
Hu Zhang ◽  
Jianhua Yang ◽  
Xinsheng Huang ◽  
Wen Liu ◽  
...  
Keyword(s):  
Finite Element ◽  
Middle Ear ◽  
Basilar Membrane ◽  
Round Window ◽  
Low Frequency ◽  
Element Model ◽  
Ossicular Chain ◽  
Asymmetric Structure ◽  
Low Frequencies ◽  
Stapes Fixation

As a novel application of implantable middle ear hearing device, round-window stimulation is widely used to treat hearing loss with middle ear disease, such as ossicular chain malformation. To evaluate the influence of ossicular chain malformations on the efficiency of the round-window stimulation, a human ear finite element model, which incorporates cochlear asymmetric structure, was constructed. Five groups of comparison with experimental data confirmed the model’s validity. Based on this model, we investigated the influence of three categories of ossicular chain malformations, that is, incudostapedial disconnection, incus and malleus fixation, and fixation of the stapes. These malformations’ effects were evaluated by comparing the equivalent sound pressures derived from the basilar membrane displacement. Results show that the studied ossicular chain malformations mainly affected the round-window simulation’s performance at low frequencies. In contrast to the fixation of the ossicles, which mainly deteriorates round-window simulation’s low-frequency performance, incudostapedial disconnection increases this performance, especially in the absence of incus process and stapes superstructure. Among the studied ossicular chain malformations, the stapes fixation has a much more severe impact on the round-window stimulation’s efficiency. Thus, the influence of the patients’ ossicular chain malformations should be considered in the design of the round-window stimulation’s actuator. The low-frequency output of the round-window simulation’s actuator should be enhanced, especially for treating the patients with stapes fixation.

Tympanosclerosis of the middle ear: Late results of surgical treatment

1990 ◽  
Vol 104 (9) ◽  
pp. 685-689 ◽  
Author(s):  
Mirko Tos ◽  
Torben Lau ◽  
Helge Arndal ◽  
Søren Plate
Keyword(s):  
Middle Ear ◽  
Ossicular Chain ◽  
Late Results ◽  
Observation Time ◽  
Type Ii ◽  
Stapes Fixation ◽  
One Stage ◽  
Stapes Footplate ◽  
Two Stages

AbstractThe late results of one stage operation for middle ear tymanosclerosis in 73 patients during the period January 1965 to December 1980 are presented. Mean observation time was 11.2 years (range 3–20.2 years), with a follow-up rate 86 per cent. Among 64 patients with stapes fixation, 59 had removal of tympanosclerotic masses and stapes mobilization, and five cases underwent stapedectomy. The series was divided into six groups and the results analyzed. The best and most stable results occurred in the group with stapes mobilization and an intact ossicular chain followed by the group with stapes mobilization and Type II tympanoplasty with incus interposition. The poorest late results were obtained in ears with lacking stapes crura and stapes mobilization, and in ears subjected to stapedectomy. No case of post-operative sensorineural hearing loss occurred. We recommend that care is taken to preserve an intact ossicular chain at stapes mobilization performed at the same stage as myringoplasty. Also in ears with a defective ossicular chain but intact stapes with tympanosclerotic fixation we recommend stapes mobilization in one stage. In ears with fixation of the stapes footplate and defective crura, we recommend stapedectomy or stapedotomy in two stages.

Ossicular chain reconstruction: endoscopic or microscopic?

2021 ◽  
pp. 1-7
Author(s):  
E A Guneri ◽  
A Cakir Cetin
Keyword(s):  
Word Recognition ◽  
Middle Ear ◽  
Risk Index ◽  
Ossicular Chain ◽  
Recognition Score ◽  
Reconstruction Surgery ◽  
Ossicular Chain Reconstruction ◽  
Operation Duration ◽  
Air Conduction

Abstract Objective To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery. Methods Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air–bone gap, air–bone gap gain, word recognition score, mean operation duration and mean post-operative follow up. Results Post-operative air conduction, air–bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air–bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air–bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001). Conclusion Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

Systematic Review and Meta-analysis of Endoscopic vs Microscopic Stapes Surgery for Stapes Fixation

2021 ◽  
pp. 019459982199066
Author(s):  
Sandra Ho ◽  
Prayag Patel ◽  
Daniel Ballard ◽  
Richard Rosenfeld ◽  
Sujana Chandrasekhar
Keyword(s):  
Postoperative Complications ◽  
Meta Analysis ◽  
Stapes Surgery ◽  
Chorda Tympani Nerve ◽  
Stapes Fixation ◽  
Operative Outcomes ◽  
Significant Difference ◽  
The Mean ◽  
Postoperative Vertigo ◽  
Hearing Outcomes

Objective To systematically review the current literature regarding the operative outcomes of stapes surgery for stapes fixation via the endoscopic and microscopic approaches. Data Sources PubMed, Embase, and Web of Science. Review Methods An electronic search was conducted with the keywords “endoscop* or microscop*” and “stapes surgery or stapedectomy or stapedotomy or otosclerosis or stapes fixation.” Studies were included if they compared endoscopy with microscopy for stapes surgery performed for stapes fixation and evaluated hearing outcomes and postoperative complications. Articles focusing on stapes surgery other than for stapes fixation were excluded. Results The database search yielded 1317 studies; 12 remained after dual-investigator screening for quantitative analysis. The mean MINORS score was 18 of 24, indicating a low risk of bias. A meta-analysis demonstrated no statistically significant difference between the groups with regard to operative time, chorda tympani nerve manipulation or sacrifice, or postoperative vertigo. There was a 2.6-dB mean improvement in the change in air-bone gap in favor of endoscopic stapes surgery and a 15.2% increased incidence in postoperative dysgeusia in the microscopic group, but the studies are heterogeneous. Conclusions Endoscopic stapes surgery appears to be a reasonable alternative to microscopic stapes surgery, with similar operative times, complications, and hearing outcomes. Superior visibility with the endoscope was consistently reported in all the studies. Future studies should have standardized methods of reporting visibility, hearing outcomes, and postoperative complications to truly establish if endoscopic stapes surgery is equivalent or superior to microscopic stapes surgery.

Ossicular Discontinuity and Exostoses in Proteus Syndrome: A Case Report

2005 ◽  
Vol 114 (3) ◽  
pp. 242-246
Author(s):  
Joni K. Doherty ◽  
Dennis R. Maceri
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Typical Feature ◽  
Proteus Syndrome ◽  
Frequency Range ◽  
Pure Tone Average ◽  
Ossicular Chain Reconstruction ◽  
Conductive Hearing

Proteus syndrome (PS) is a rare hamartomatous disorder characterized by mosaic overgrowth of multiple tissues that manifests early in life and is progressive. The presence of unilateral external auditory canal exostoses in a patient who is not a swimmer or surfer is suggestive of PS. However, hearing loss is not a typical feature. Here, we describe exostoses and ossicular discontinuity with conductive hearing loss in a patient with PS. The treatment consisted of canalplasty and ossicular chain reconstruction. A postoperative reduction was demonstrated in the patient's air-bone gap, from 21 dB to 13 dB for the pure tone average (four frequencies) and from 41 dB to 15 dB in the high-frequency range (6,000 to 8,000 Hz). Causes of ossicular discontinuity are discussed. Routine annual audiometric and otolaryngological evaluation should be considered in all patients with temporal bone inyolvement of PS.

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