scholarly journals TOTAL ENDOSCOPIC STAPES SURGERY. OUR TECHNIQUE AND EXPERIENCE OF 45 CASES

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S491-94
Author(s):  
Muhammad Atif Najam ◽  
Urwa Sarwar ◽  
Maqbool Raza ◽  
Khalid Azam Khan ◽  
Humaira Saleem ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Demographic Data ◽  
Stapes Surgery ◽  
Chorda Tympani ◽  
Steep Learning Curve ◽  
Hearing Results ◽  
Stapedial Artery ◽  
Ear Anomalies ◽  
Postoperative Vertigo ◽  
Endoscopic Stapedotomy

Objective: To assess the hearing results of transcanal endoscopic stapedotomy Study Design: Descriptive study. Place and Duration of Study: Pakistan Naval Ship Hafeez Islamabad Pakistan, from Jun 2016 to Jun 2020. Methodology: All patients with surgically confirmed otosclerosis were included in the study. All patients were operated with 0-degree 3mm, 14cm rigid endoscope under general anesthesia. Preoperative and post operative air bone gap was noted along with demographic data, middle ear anomalies (persistent stapedial artery, dehiscent facial nerve, anteriorly placed facial nerve, floating foot plate) and injury to chorda tympani. Postoperative air bone gap (A-B Gap) was documented 12 weeks after surgery. All patients were followed up for 6-12 months Results: Mean age of patients was, 37 years and standard deviation was 12.34 (range 27-52 years). Out of total 45 cases 13 were males (29%) and 32 females (71.%). Four (8.8%) patients had dehiscent facial canal and 1 (2.2%) patient had persistent stapedial artery. Average preoperative A-B gap was 35 db and Average Postoperative A-B Gap was 7 db. Chorda tympani was preserved in all cases. One patient (2.2%) complained of altered taste which resolved after 3 months. Four patients had Postoperative vertigo that lasted 2 days on average. Conclusion: Endoscopic trans canal Stapes surgery is scarless safe effective procedure demonstrable hearing benefits in all patients with minimum complications. The Technique is single handed and has steep learning curve.

scholarly journals Postoperative radiological assessment of the mastoid facial canal in cochlear implant patients in correlation with facial nerve stimulation

2021 ◽  
Author(s):  
Iris Burck ◽  
Rania A. Helal ◽  
Nagy N. N. Naguib ◽  
Nour-Eldin A. Nour-Eldin ◽  
Jan-Erik Scholtz ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Cochlear Implant ◽  
Nerve Stimulation ◽  
Lateral Wall ◽  
Facial Canal ◽  
Chorda Tympani ◽  
Radiological Assessment ◽  
Canal Diameter ◽  
History Of ◽  
Facial Nerve Stimulation

Abstract Objectives To correlate the radiological assessment of the mastoid facial canal in postoperative cochlear implant (CI) cone-beam CT (CBCT) and other possible contributing clinical or implant-related factors with postoperative facial nerve stimulation (FNS) occurrence. Methods Two experienced radiologists evaluated retrospectively 215 postoperative post-CI CBCT examinations. The mastoid facial canal diameter, wall thickness, distance between the electrode cable and mastoid facial canal, and facial-chorda tympani angle were assessed. Additionally, the intracochlear position and the insertion angle and depth of electrodes were evaluated. Clinical data were analyzed for postoperative FNS within 1.5-year follow-up, CI type, onset, and causes for hearing loss such as otosclerosis, meningitis, and history of previous ear surgeries. Postoperative FNS was correlated with the measurements and clinical data using logistic regression. Results Within the study population (mean age: 56 ± 18 years), ten patients presented with FNS. The correlations between FNS and facial canal diameter (p = 0.09), wall thickness (p = 0.27), distance to CI cable (p = 0.44), and angle with chorda tympani (p = 0.75) were statistically non-significant. There were statistical significances for previous history of meningitis/encephalitis (p = 0.001), extracochlear-electrode-contacts (p = 0.002), scala-vestibuli position (p = 0.02), younger patients’ age (p = 0.03), lateral-wall-electrode type (p = 0.04), and early/childhood onset hearing loss (p = 0.04). Histories of meningitis/encephalitis and extracochlear-electrode-contacts were included in the first two steps of the multivariate logistic regression. Conclusion The mastoid-facial canal radiological assessment and the positional relationship with the CI electrode provide no predictor of postoperative FNS. Histories of meningitis/encephalitis and extracochlear-electrode-contacts are important risk factors. Key Points • Post-operative radiological assessment of the mastoid facial canal and the positional relationship with the CI electrode provide no predictor of post-cochlear implant facial nerve stimulation. • Radiological detection of extracochlear electrode contacts and the previous clinical history of meningitis/encephalitis are two important risk factors for postoperative facial nerve stimulation in cochlear implant patients. • The presence of scala vestibuli electrode insertion as well as the lateral wall electrode type, the younger patient’s age, and early onset of SNHL can play important role in the prediction of post-cochlear implant facial nerve stimulation.

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.

Persistent stapedial artery

1992 ◽  
Vol 106 (3) ◽  
pp. 254-257 ◽  
Author(s):  
A. L. Pahor ◽  
S. S. M. Hussain
Keyword(s):  
Ct Scan ◽  
Middle Ear ◽  
Stapes Surgery ◽  
Technical Problems ◽  
Stapedial Artery

AbstractPersistence of the stapedial artery is rare. A case is presented in which the stapedial artery was found over the footplate during stapes surgery. The technical problems encountered are discussed.A wire prosthesis has previously been used in the presence of a persistent stapedial artery and we describe the use of an all Teflon prosthesis.A subsequent CT scan demonstrated the vessel in the middle ear.An outline of the embryology of the stapedial artery is given and the literature reviewed.

Persistence of the Stapedial Artery: A Histopathologic Study

1985 ◽  
Vol 93 (3) ◽  
pp. 298-312 ◽  
Author(s):  
Mitchell Marion ◽  
Raúl Hinojosa ◽  
Anwar A. Khan
Keyword(s):  
Facial Nerve ◽  
Clinical Significance ◽  
Rare Event ◽  
Middle Meningeal Artery ◽  
The Third ◽  
Histopathologic Study ◽  
Stapedial Artery ◽  
Developmental Theories ◽  
Temporal Bones ◽  
Meningeal Artery

Persistence of the stapedial artery is a rare event. Fewer than 30 cases have been reported since the discovery of this artery in 1836. We carried out a histopathologic study on three temporal bones from two patients who had this anomaly, and were able to trace the full course of the artery. In two specimens a large stapedial artery persisted and substituted for the middle meningeal artery. In the third, a small, persistent stapedial artery ended in the arterial plexus surrounding the facial nerve. Persistence is discussed in terms of embryogenesis, developmental theories, histologic findings, and clinical significance. The material suggests that the stapedial artery can persist to varying degrees

Change of somatosensory function of the tongue caused by chorda tympani nerve disorder after stapes surgery

2017 ◽  
Vol 128 (3) ◽  
pp. 701-706 ◽  
Author(s):  
Emi Maeda ◽  
Hirokazu Katsura ◽  
Tomomi Nin ◽  
Akiko Sakaguchi-Fukunaga ◽  
Yasuo Mishiro ◽  
...  
Keyword(s):  
Stapes Surgery ◽  
Chorda Tympani ◽  
Chorda Tympani Nerve ◽  
Somatosensory Function

scholarly journals Facial nerve anomalies in paediatric cochlear implant candidates: radiological evaluation

2016 ◽  
Vol 131 (1) ◽  
pp. 26-31 ◽  
Author(s):  
F B Palabiyik ◽  
K Hacikurt ◽  
Z Yazici
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Facial Nerve ◽  
Cochlear Implant ◽  
Inner Ear ◽  
Resonance Imaging ◽  
High Resolution Computed Tomography ◽  
Ear Anomalies

AbstractBackground:Pre-operative radiological identification of facial nerve anomalies can help prevent intra-operative facial nerve injury during cochlear implantation. This study aimed to evaluate the incidence and configuration of facial nerve anomalies and their concurrence with inner-ear anomalies in cochlear implant candidates.Methods:Inner-ear and concomitant facial nerve anomalies were evaluated by magnetic resonance imaging and temporal high-resolution computed tomography in 48 children with congenital sensorineural hearing loss who were cochlear implant candidates.Results:Inner-ear anomalies were present in 11 out of 48 patients (23 per cent) and concomitant facial nerve anomalies were present on 7 sides in 4 patients (7 per cent of the total). Facial nerve anomalies were accompanied by cochlear or vestibular malformation.Conclusion:Potential facial nerve abnormalities should always be considered in patients with inner-ear anomalies. Pre-operative facial nerve imaging can increase the surgeon's confidence to plan and perform cochlear implantation. Magnetic resonance imaging should be used to detect inner-ear anomalies; if these are identified, temporal high-resolution computed tomography should be used to evaluate the facial nerve.

Fixation of the Anterior Mallear Ligament: Diagnosis and Consequences for Hearing Results in Stapes Surgery

2003 ◽  
Vol 112 (4) ◽  
pp. 348-355 ◽  
Author(s):  
Alexander Huber ◽  
Takuji Koike ◽  
Vel Nandapalan ◽  
Hiroshi Wada ◽  
Ugo Fisch
Keyword(s):  
Finite Element ◽  
Hearing Loss ◽  
Vibration Amplitude ◽  
Conductive Hearing Loss ◽  
Stapes Surgery ◽  
Hearing Results ◽  
Functional Failure ◽  
Human Temporal Bone ◽  
Manual Palpation ◽  
Conductive Hearing

In the search for possible causes of unfavorable results after stapes surgery, the study reported here focused on the anterior mallear ligament, since it has been previously reported that partial mallear fixation (PMF) leads to functional failure in 38% of cases of stapes revision surgery. The aims of the study were to identify effective methods for the diagnosis of PMF and experimentally assess the conductive hearing loss that results from PMF. The study included vibration amplitude measurements of the ossicles by laser Doppler interferometry (LDI) in 19 patients and 5 fresh human temporal bone (TB) specimens. Analysis of their dynamic behavior was performed by finite element modeling (FEM). Similar, significant changes of manubrium vibration patterns for PMF were found by FEM calculations, in TB experiments, and in patients. We could identify PMF either before operation, using LDI, or during operation, by manual palpation. In the TB experiments and FEM calculations, the attenuation of the stapes displacement due to an isolated PMF was approximately 10 dB and frequency-dependent. Untreated anterior mallear ligament fixation produced a persistent air-bone gap of approximately 10 dB after stapedioplasty.

Stapes surgery with a persistent stapedial artery

2020 ◽  
Vol 41 (6) ◽  
pp. 102684
Author(s):  
Pedrom C. Sioshansi ◽  
Amy E. Schettino ◽  
Seilesh C. Babu ◽  
Dennis I. Bojrab ◽  
Elias M. Michaelides ◽  
...  
Keyword(s):  
Stapes Surgery ◽  
Stapedial Artery
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