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Stapes prosthesis

Inge Wegner, Robert Vincent, Laura S M Derks, Simone P Rauh, Martijn W Heymans, Inge Stegeman, Wilko Grolman
OBJECTIVES/HYPOTHESIS: To develop a prediction model that can accurately predict the chance of success following revision stapes surgery in patients with recurrent or persistent otosclerosis at 2- to 6-months follow-up and to validate this model internally. STUDY DESIGN: A retrospective cohort study of prospectively gathered data in a tertiary referral center. METHODS: The associations of 11 prognostic factors with treatment success were tested in 705 cases using multivariable logistic regression analysis with backward selection...
March 9, 2018: Laryngoscope
Badi Aldosari, Jean-Marc Thomassin
Objective: The purpose of this study is to evaluate our experience with endoscopic repair of ossicular discontinuity at the incudostapedial joint, with or without an intact stapes suprastructure, and present our hearing results. We classify results based on the causative pathology, the type of ossiculoplasty, and type of lesion. We demonstrate the ability to endoscopically place a total ossicular replacement prosthesis (TORP), measuring 4.25 mm, between the stapes footplate and the incus remnant to reestablish ossicular continuity...
September 2017: World Journal of Otorhinolaryngology—Head and Neck Surgery
Alexander Sevy, Moises Arriaga
Since the original carved Teflon stapes over vein graft, stapedectomy prostheses have undergone evolution. Prostheses shapes, materials, and surgical techniques for placement have reflected advances in biomaterials and surgical tools. The variability in prostheses has reflected alternative techniques of stapedectomy and stapedotomy and differing strategies for attachment to the incus. Although many iterations of stapes prostheses have been proposed, excellent results can be achieved with various prostheses designed to rest on tissue grafts in stapedectomy techniques or pass through the footplate in stapedotomy techniques when used by surgeons experienced with technique details specific to the selected prosthesis...
April 2018: Otolaryngologic Clinics of North America
Amit Wolfovitz, Michal Luntz
The use of imaging in otosclerosis for diagnosis, preoperative assessment, and follow-up has the potential to give the clinician an additional tier of patient evaluation and validation of diagnosis. Before stapes surgery, imaging may help avoid unnecessary middle ear explorations in nonotosclerotic cases, prevent potential complications, and assist in appropriate patient counseling regarding management expectations. Postoperatively, following unsuccessful air-bone gap closure in stapes surgery or conductive hearing deterioration following initial successful closure of the air bone gap, imaging can be used to determine the prosthesis position in the middle ear...
April 2018: Otolaryngologic Clinics of North America
Margaret Aron, Thomas G Landry, Manohar Bance
BACKGROUND: Total ossicular replacement prostheses (TORP) are often used to re-establish ossicular coupling of sound in an ear lacking a stapes supra-structure. The use of TORPs, however, is associated with a 2/3 five year failure rate due to their anatomic instability over time in the middle ear. The use of autologous fat to try and stabilize TORPs may improve long-term results with this challenging ossicular reconstruction technique. METHODS: A cadaveric temporal bone model was developed and laser Doppler vibrometry was used to measure and record round window membrane vibration in response to sound stimulation under the following conditions: normal middle ear, middle ear filled with fat, normal middle ear with TORP prosthesis, TORP prosthesis with fat around its distal end and TORP prosthesis with fat filling the middle ear...
February 17, 2018: Journal of Otolaryngology—Head & Neck Surgery
Brandon Isaacson, Jacob B Hunter, Alejandro Rivas
The management of stapes fixation using transcanal endoscopic ear surgery is a viable alternative approach. The advantages of transcanal endoscopic ear surgery are improved visualization and illumination of the stapes and oval window regardless of the size and geometry of the external auditory canal. Footplate work and prosthesis placement pose significant but surmountable challenges using transcanal endoscopic ear surgery secondary to the lack of depth perception. Several recent studies demonstrate the efficacy and safety of transcanal endoscopic ear surgery...
April 2018: Otolaryngologic Clinics of North America
Anders Niklasson, Kilian Gladiné, Anton Rönnblom, Magnus von Unge, Joris Dirckx, Krister Tano
OBJECTIVE: To compare stapes vibrations in different partial ossicular replacement prosthesis (PORP) applications. METHODS: Stapedial vibrations were measured on fresh frozen human temporal bones with laser Doppler vibrometry. Eight different types of common ossiculoplasty methods were compared regarding recovery of stapes vibrations in relation with the normal ossicular chain. The PORPs were divided into three groups: 1) PORPs with the lateral contact only with the tympanic membrane, 2) PORPs with lateral contact only to the malleus handle, and 3) PORPs with lateral contact with both the malleus handle and the tympanic membrane...
March 2018: Otology & Neurotology
Issam Saliba, Valérie Sabbah, Jackie Bibeau Poirier
Objective: To compare audiometric results between the standard total ossicular replacement prosthesis (TORP-S) and a new fat interposition total ossicular replacement prosthesis (TORP-F) in pediatric and adult patients and to assess the complication and the undesirable outcome. Study design: This is a retrospective study. Methods: This study included 104 patients who had undergone titanium implants with TORP-F and 54 patients who had undergone the procedure with TORP-S between 2008 and 2013 in our tertiary care centers...
2018: Clinical Medicine Insights. Ear, Nose and Throat
A I Kryukov, E V Garov, E I Zelikovich, N G Sidorina, O V Fedorova, V N Zelenkova, A S Kaloshina, E E Zagorskaya, G V Kurilenkov, V E Kiselyus
This article presents the results of analysis of the data obtained during the examination and the surgical treatment of the patients presenting with the obliterative form of otosclerosis and suffering from hearing impairment with special reference to the intraoperative findings, technical aspects of stapedoplasty, and its effectiveness. A total of 14 patients (17 ears) were recruited for the participation in the present study including 10 women at the mean age of 38.8±6.2 years and 4 men (mean age 44.8±3...
2017: Vestnik Otorinolaringologii
Daniele Bernardeschi, Daniele De Seta, Giuseppina Canu, Francesca Yoshie Russo, Evelyne Ferrary, Ghizlene Lahlou, Olivier Sterkers
OBJECTIVES/HYPOTHESIS: To evaluate the influence of the diameter of stapes prosthesis on functional outcomes in stapes surgery. STUDY DESIGN: Prospective cohort study. METHODS: Fifty consecutive small fenestra stapedotomies performed using a 0.4-mm-diameter prosthesis were compared with 50 consecutive small fenestra stapedotomies carried out using a 0.6-mm-diameter piston. Audiological assessment following the recommendations of the Committee on Hearing and Equilibrium was performed 1 month after surgery...
November 24, 2017: Laryngoscope
Florian Schrötzlmair, Fabian Suchan, Thomas Pongratz, Eike Krause, Joachim Müller, Ronald Sroka
BACKGROUND AND OBJECTIVE: Otosclerosis is an inner ear bone disease characterized by fixation of the stapes and consequently progressive hearing loss. One treatment option is the surgical replacement of the stapes by a prosthesis. When so called "smart materials" like nitinol are used, prosthesis fixation can be performed using a laser without manual crimping on the incus. However, specific laser-prosthesis interactions have not been described yet. The aim of the present study was to elucidate the thermo-mechanical properties of the NiTiBOND® prosthesis as a basis for handling instructions for laser-assisted prosthesis fixation...
November 2, 2017: Lasers in Surgery and Medicine
Juan Luis Quesada, Giovanni Cammaroto, Lilla Bonanno, Francesco Galletti, Pedro Quesada
Cerebrospinal fluid (CSF) leak is an uncommon event that can occur during stapes surgery. Such leaks can be classified as gushing leaks (stapes gushers) and oozing leaks. A stapes gusher is a massive flow of CSF through the perforated footplate that fills the middle ear suddenly, while an oozing leak is a slower and less profuse flow. We conducted a retrospective, observational, multicenter study of 38 patients-23 men and 15 women, aged 23 to 71 years (mean: 47)-who had experienced a CSF leak during stapes surgery...
August 2017: Ear, Nose, & Throat Journal
Mathias Müller, Rolf Salcher, Thomas Lenarz, Hannes Maier
INTRODUCTION: Stimulation of the cochlear round window (RW) with the floating mass transducer (FMT) still suffers from large variation in clinical outcomes. Beside the geometric mismatch between RW and FMT diameter that is a known limiting factor in achieving optimal coupling between actuator and RW membrane, the applied static force between FMT and RW is usually undefined. In this study, the feasibility and efficacy of a specially designed FMT coupler permitting application of static preloads to the RW membrane to optimize FMT-RW coupling was investigated...
September 2017: Otology & Neurotology
Pingling Kwok, Otto Gleich, Katharina Dalles, Elisabeth Mayr, Peter Jacob, Jürgen Strutz
OBJECTIVE: To evaluate, whether a learning curve for beginners in stapedotomy can be avoided by using a prosthesis with thermal memory-shape attachment in combination with a standardized laser-assisted surgical technique. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Fifty-eight ears were operated by three experienced surgeons and compared with a group of 12 cases operated by a beginner in stapedotomy...
August 2017: Otology & Neurotology
Qasim Husain, Kenny F Lin, Samuel H Selesnick
OBJECTIVES: First, to determine if prosthesis length plays a role in optimizing successful hearing outcomes in stapedotomy surgery; and second, to determine if patient factors such as height are correlated with prosthesis length. STUDY DESIGN: Retrospective chart review. METHODS: Retrospective chart review of patients undergoing stapedotomy surgeries with adequate follow up. Length of prosthesis, pre-/postoperative audiograms, and follow-up data were obtained...
May 31, 2017: Laryngoscope
Monika Kwacz, Magdalena Sołyga, Maciej Mrówka, Konrad Kamieniecki
Piston-stapedotomy is the most common method for hearing restoration in patients with otosclerosis. In this study, we have experimentally examined a prototype of a new chamber stapes prosthesis. The prototype was implanted in a human cadaver temporal bone. The round window vibrations before and after implantation were measured for the acoustic signal (90 dB SPL, 0.8-8 kHz) in the external auditory canal. In comparison with a 0.4-mm piston prosthesis, the chamber prosthesis induced significantly higher vibration of the round window, especially for frequencies above 1...
2017: PloS One
Susen Lailach, Thomas Zahnert, Marcus Neudert
Objective The objective of our study was to check the documentation of hearing outcome parameters and influencing factors (surgical, pathological, and methodological) in published literature evaluating hearing outcome after tympanoplasty. We aimed to assess how effectively the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) 1995 guidelines were applied. Study Design Retrospective noncontrolled study. Setting Ear research center. Subjects and Methods This study was based on a PubMed research, including peer-reviewed English-speaking original studies published from January 2005 to December 2015...
August 2017: Otolaryngology—Head and Neck Surgery
Brandon Kamrava, Pamela C Roehm
Objective To systematically review the anatomy of the ossicular chain. Data Sources Google Scholar, PubMed, and otologic textbooks. Review Methods A systematic literature search was performed on January 26, 2015. Search terms used to discover articles consisted of combinations of 2 keywords. One keyword from both groups was used: [ ossicular, ossicle, malleus, incus, stapes] and [ morphology, morphometric, anatomy, variation, physiology], yielding more than 50,000 hits. Articles were then screened by title and abstract if they did not contain information relevant to human ossicular chain anatomy...
August 2017: Otolaryngology—Head and Neck Surgery
Scott A Hardison, Grace Pyon, Audrey Le, Wen Wan, Daniel H Coelho
Objective To determine whether double gloving would negatively affect participants' ability to perform a simulated microsurgical task. Study Design Randomized single-blinded controlled crossover trial. Setting Temporal bone laboratory of an academic otolaryngology department. Subjects and Methods This study involved the simulated insertion of a stapes prosthesis into a model of the ossicular chain under microscopy. Forty-one participants were recruited from our medical and dental school and randomized into 2 groups...
September 2017: Otolaryngology—Head and Neck Surgery
Yann Nguyen, Elisabeth Mamelle, Daniele De Seta, Olivier Sterkers, Daniele Bernardeschi, Renato Torres
Functional outcomes and complications in otosclerosis surgery are governed by the surgeon's experience. Thus, teaching the procedure to residents to guide them through the learning process as quickly as possible is challenging. Artificial 3D-printed temporal bones are replacing cadaver specimens in many institutions to learn mastoidectomy, but these are not suitable for middle ear surgery training. The goal of this work was to adapt such an artificial temporal bone to aid the teaching of otosclerosis surgery and to evaluate this tool...
July 2017: European Archives of Oto-rhino-laryngology
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