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Stapes prosthesis

Thomas Zahnert, Marie-Luise Metasch, Hannes Seidler, Matthias Bornitz, Nicoloz Lasurashvili, Marcus Neudert
HYPOTHESIS: Electromagnetical excitation of ossicular vibration is suitable for middle ear transmission measurements in the experimental and clinical setting. Thereby, it can be used as a real-time monitoring system for quality control in ossiculoplasty. BACKGROUND: Positioning and coupling of middle ear prosthesis are a precondition for good postoperative hearing results, but at the same time completely dependent upon the surgeon's subjective judgment during surgery...
October 4, 2016: Otology & Neurotology
Ana Castro Sousa, Vânia Henriques, Jorge Rodrigues, Rui Fonseca
BACKGROUND AND OBJECTIVES: The goal of ossiculoplasty is to improve hearing. Successful ossiculoplasty depends on several factors. This retrospective study was carried out to analyze hearing results of ossiculoplasty in ears with chronic otitis media (COM) and evaluate clinical outcomes and factors predictive of hearing improvement. SUBJECTS AND METHODS: We reviewed the results of 153 patients with COM (with cholesteatoma (COMC) and without cholesteatoma (COMWC)) who underwent ossiculoplasty between January of 2002 to December of 2011...
September 20, 2016: Acta Otorrinolaringológica Española
Vânia Henriques, Rafaela Teles, Ana Sousa, Roberto Estevão, Jorge Rodrigues, Alexandra Gomes, Francisco Silva, Ângelo Fernandes, Fausto Fernandes
Congenital middle ear malformations are rare. Most part of them are usually associated with other malformations, such as aural atresia, microtia, and dysmorphic craniofacial features. A clinical case of a 24-year-old male with a right-sided conductive hearing loss since his childhood, without craniofacial malformation, is presented. He was proposed for exploratory tympanotomy under the suspicious diagnosis of otosclerosis. The surgery revealed an abnormal location of stapes' superstructure, which was attached to the promontory and had an isolated and mobile osseous footplate in the oval window...
2016: Case Reports in Otolaryngology
Inge Wegner, Mostafa M A S Eldaebes, Thomas G Landry, Wilko Grolman, Manohar L Bance
HYPOTHESIS: The use of larger-diameter pistons in stapedotomy leads to better hearing outcomes compared with the use of smaller-diameter pistons. There is an interaction between stapes piston diameter and fenestration diameter. BACKGROUND: Otosclerosis can be treated surgically by removing part of the stapes and bypassing the stapes footplate with a prosthesis. Available piston shaft diameters range between 0.3 and 0.8 mm. There has been a tendency toward the use of smaller-diameter pistons, because of a suspected decreased risk of cochlear trauma and subsequent sensorineural hearing loss (SNHL) with smaller pistons...
September 16, 2016: Otology & Neurotology
Marcus Neudert, Matthias Bornitz, Nikoloz Lasurashvili, Uwe Schmidt, Thomas Beleites, Thomas Zahnert
HYPOTHESIS: Prosthesis' length creates tension in ossicular reconstructions, which directly effects the middle ear sound transmission. BACKGROUND: Relatively long prostheses are often used to stabilize the middle ear reconstruction to prevent dislocation. Thereby, tension on the flexible components such as the tympanic membrane (TM) and the annular ligament (AL) is increased. Only little is known on the amount of displacement-related stiffening of the TM and AL, as well as the consecutive reduction in middle ear transfer function (METF)...
October 2016: Otology & Neurotology
Jeon Mi Lee, Jinsei Jung, In Seok Moon, Sung Huhn Kim, Jae Young Choi
OBJECTIVES/HYPOTHESIS: We compared the audiologic benefits of active middle ear implants with those of passive middle ear implants with hearing aids in mixed hearing loss, and also compared the outcomes of stapes vibroplasty with those of round window vibroplasty. STUDY DESIGN: Retrospective chart review. METHODS: Thirty-four patients with mixed hearing loss due to chronic otitis media were treated with a middle ear implant. Of these, 15 were treated with a passive middle ear implant (conventional ossiculoplasty with a partial ossicular replacement prosthesis), nine with an active middle ear implant coupling to the stapes, and 10 with an active middle ear implant coupling to the round window...
August 25, 2016: Laryngoscope
Antoniu-Oreste Gostian, Jean-Marc Kouamé, Martin Bremke, Magdalene Ortmann, Karl-Bernd Hüttenbrink, Dirk Beutner
Importance: Multiple techniques for a more secure and stable anchoring of the foot of a total ossicular replacement prosthesis (TORP) on the footplate have been proposed. To address this issue, a technique was developed that fits a cartilage shoe into the oval niche to guide the base of the prosthesis into a preformed central perforation. Objective: To evaluate the long-term results of the cartilage shoe technique used to anchor a titanium TORP on the stapes footplate in patients after type III tympanoplasty...
August 18, 2016: JAMA Otolaryngology—Head & Neck Surgery
Inge Wegner, Navid Shahnaz, Wilko Grolman, Manohar L Bance
OBJECTIVE: To ascertain if wideband acoustic immitance (WAI) measurements are useful in assessing crimping status following stapedotomy. DESIGN: WAI measurements were obtained using the Mimosa Acoustics HearID system. Wideband chirp sound stimuli and a set of tone stimuli for nine frequencies between 0.2 and 6 kHz were used at 60 dB SPL. Five sets of measurements were performed on each temporal bone: mobile stapes, stapes fixation and stapedotomy followed by insertion of a tightly crimped, a loosely crimped and an uncrimped prosthesis...
August 18, 2016: International Journal of Audiology
Vivian F Zhu, Yann-Fuu Kou, Kenneth H Lee, Joe Walter Kutz, Brandon Isaacson
OBJECTIVES: 1) To describe the technique for transcanal endoscopic management of congenital ossicular chain fixation. 2) To highlight the utility and outcomes of the endoscopic approach for management of congenital ossicular fixation. STUDY DESIGN: Retrospective patient series. SETTING: Academic tertiary pediatric hospital. PATIENTS: Pediatric patients (age 6-12) undergoing transcanal endoscopic management of congenital ossicular fixation from May 2014 to December 2014...
September 2016: Otology & Neurotology
Katarzyna Banasik, Monika Kwacz
Stapes protheses are designed for patients with otosclerosis resulting immobilization or significant reduction of the stapes mobility. All currently used prostheses are called - piston prosthesis. However, its use to stimulate the cochlea is still imperfect. New chamber stapes prosthesis allows the perilymph excitation more effective than the piston prothesis. Moreover, the chamber prosthesis eliminates the common causes of piston-stapedotomy failures. The most important element of the new prosthesis is a flexible membrane...
June 30, 2016: Otolaryngologia Polska. the Polish Otolaryngology
Kenny F Lin, Samuel Selesnick
OBJECTIVE: To evaluate hearing outcomes and incidence of sensorineural hearing loss (SNHL) after stapedotomy with adipose tissue seal, and to compare adipose tissue sealing with alternative techniques. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. PATIENTS: Primary stapedotomy was performed in 179 patients using a KTP laser, microdrill, piston prosthesis, and adipose tissue seal of the oval window fenestra between 1991 and 2015...
August 2016: Otology & Neurotology
Jan Christoffer Lüers, David Schwarz, Andreas Anagiotos, Antoniu-Oreste Gostian, Dirk Beutner, Karl Bernd Hüttenbrink
OBJECTIVE: Analysis of the audiometric results after repair of a defective footplate with the sandwich cartilage shoe technique in a follow-up study. STUDY DESIGN: Retrospective analysis of audiometric data. SETTING: Hospital. PATIENTS: The cohort consisted of 12 patients, who underwent ossicular reconstruction after sandwich cartilage shoe technique in a case of insecure stapes footplate. The mean age was 42.7 years with an equal sex distribution...
August 2016: Otology & Neurotology
Volkan Gungor, Gamze Atay, M Demir Bajin, Mehmet Yarali, Sarp Sarac, Levent Sennaroglu
OBJECTIVE: In this study, functional results of different bone cement ossiculoplasty techniques are compared. METHODS: Retrospective case review at a tertiary referral center. Patients who underwent middle ear surgery and bone cement ossiculoplasty between 2006-2012 were included. A total of 52 patients, including 30 patients with 'Incus to stapes' (Group 1) and 13 patients with 'malleus to stapes' (Group 2), five patients with 'incudoplasty + stapedotomy' (Group 3), and four patients with 'malleus to incus' (Group 4) ossiculoplasty were enrolled in the study...
September 2016: Acta Oto-laryngologica
Maurizio Barbara, Luigi Volpini, Edoardo Covelli, Chiara Filippi, Simonetta Monini
OBJECTIVE: To verify the efficacy of a powerful active hearing device in a patient different from far-advanced otosclerosis, specifically when the stapes footplate is mobile. PATIENT: A patient with severe-to-profound mixed hearing loss, who was not benefiting from the use of a conventional hearing aid, was selected for an inner ear active implant. This was justified by a bone conductive threshold above 60 dB, which had discouraged any other rehabilitative solutions such as a bone conductive implant, or an active middle ear implant (AMEI)...
June 2016: Otology & Neurotology
Mohan Bansal
Otosclerosis is the most common cause of bilateral gradually progressive conductive hearing loss with normal tympanic membrane and Eustachian tube. Otosclerosis surgical treatment is one of the most gratifying operations in Otorhinolaryngology. It is not only the surgical techniques but also the prosthesis which are evolving in the attempt of providing best hearing results. Teflon piston is the most commonly employed prosthesis in stapes surgery. Titanium pistons are relatively the new development in the evolution of stapes prosthesis...
March 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
Peter K Gottlieb, Xiping Li, Ashkan Monfared, Nikolas Blevins, Sunil Puria
OBJECTIVES/HYPOTHESIS: The performance of an ossicular replacement prosthesis (ORP) is influenced by its alignment and appropriate tension between the tympanic membrane and the stapes footplate. A novel ORP with a flexible element that potentially allows for length adjustment in situ is presented and tested for acoustic performance. STUDY DESIGN: Laser Doppler vibrometry in fresh human cadaveric temporal bones was used to test the acoustic performance of the adjustable ORP relative to standard prostheses used for ossiculoplasty...
March 12, 2016: Laryngoscope
Nihal Efe Atila, Korhan Kilic, Muhammed Sedat Sakat, Enver Altas, Harun Ucuncu, Yunus Emre Bulut
PURPOSE: We aimed to determine the effect of a cartilage shoe graft placed between the foot of the TORP and the stapes footplate on hearing improvement and long-term displacement rates. MATERIALS AND METHODS: Patients who underwent TORP ossiculoplasty were divided into two groups. The TORP-alone group consisted of 32 patients who underwent TORP placement without cartilage shoe graft and served as the control group. The study group consisted of 56 patients who underwent placement of cartilage shoe graft together with TORP...
March 2016: American Journal of Otolaryngology
Robert Vincent, Inge Wegner, Digna M A Kamalski, Arnold J N Bittermann, Wilko Grolman
OBJECTIVE: To evaluate surgical findings and hearing results in children undergoing middle ear surgery for congenital stapes ankylosis with or without other ossicular malformations (Teunissen and Cremers class I and class II malformations). STUDY DESIGN: A nonrandomized, nonblinded case series of prospectively collected data. SETTING: A tertiary referral center. PATIENTS: Twenty-eight consecutive pediatric patients who underwent 35 surgical procedures for congenital stapes ankylosis with or without other ossicular malformations and had available postoperative pure-tone audiometry...
April 2016: Otology & Neurotology
Yanqing Fang, Bing Wang, John J Galvin, Duoduo Tao, Rui Deng, Xiong Ou, Yangwenyi Liu, Peidong Dai, Yan Sha, Tianyu Zhang, Bing Chen
OBJECTIVES: The aims of this article are: 1) to re-evaluate the accuracy of multiple planar reconstruction computed tomography (MPR-CT) imaging on stapes-prosthesis parameters, and 2) to clarify possible relationships between prosthesis intravestibular depth and postoperative hearing outcomes. PATIENTS: Seventy patients (46 women and 24 men; 32 right and 38 left sides) with the mean age of 40 years (range, 19-62 yr) with clinical otosclerosis. INTERVENTION(S): All patients underwent stapedotomy and were implanted with the same type of titanium piston prosthesis by the same surgeon...
April 2016: Otology & Neurotology
Laura S M Derks, Inge Wegner, Rinze A Tange, Digna M A Kamalski, Wilko Grolman
BACKGROUND: Otosclerosis is characterized by bony deposits in the otic capsule, resulting in stapes fixation and progressive hearing loss. It can be treated effectively by surgically removing (part of) the stapes and replacing it with a prosthesis. Increasingly, stapes surgery is performed as a day-case procedure. The major drive towards day-case surgery has been out of economic considerations. However, it is also increasingly an explicit patient request and leads to shorter waiting times for surgery, a reduced risk of infection and most likely positively influences the patient's quality of life as a result of rapid discharge and rehabilitation...
2016: BMC Ear, Nose, and Throat Disorders
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