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Hannes Petersen, Alexandra Gliese, Yannick Stober, Stephanie Maier, Nils-Owe Hansen, Sebastian Kruber, Dennis Eggert, Miklós Tóth, Tobias Gosau, Hartmut Schlüter, Klaus Püschel, Udo Schumacher, Robert John Dwayne Miller, Adrian Münscher, Carsten Dalchow
OBJECTIVE: Using a contact-free laser technique for stapedotomy reduces the risk of mechanical damage of the stapes footplate. However, the risk of inner ear dysfunction due to thermal, acoustic, or direct damage has still not been solved. The objective of this study was to describe the first experiences in footplate perforation in cadaver tissue performed by the novel Picosecond-Infrared-Laser (PIRL), allowing a tissue preserving ablation. PATIENTS AND INTERVENTION: Three human cadaver stapes were perforated using a fiber-coupled PIRL...
April 2018: Otology & Neurotology
John T McElveen, J Walter Kutz
Controversies have been associated with the etiology, diagnosis, evaluation, and management of otosclerosis since Valsalva first described stapes fixation as a cause of hearing loss. Although the exact mechanism of the bone remodeling associated with otosclerosis remains uncertain, stapedotomy has been accepted as the surgical treatment of most patients with stapedial otosclerosis. There remains a disparity of opinion, however, regarding the role of preoperative imaging, surgical technique, implant selection, and medical therapy for cochlear otosclerosis...
April 2018: Otolaryngologic Clinics of North America
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
Dhooge Ingeborg, Desmedt Stéphanie, Maly Thomas, Loose David, Van Hoecke Helen
OBJECTIVE: To evaluate long-term hearing results of stapedotomy and analyze the influence of patient-, disease-, and procedure-related variables. STUDY DESIGN: Retrospective case series. SETTING: Tertiary referral center. PATIENTS: 230 ears (202 patients, 10-74 years) underwent stapedotomy for otosclerosis between January 2008 and August 2014. All cases had early postoperative follow-up (4 weeks post-surgery) and 181 cases had late postoperative follow-up (≥ 1 year, average 32...
February 16, 2018: European Archives of Oto-rhino-laryngology
Horace C S Cheng, Sumit K Agrawal, Lorne S Parnes
Stapedectomy and stapedotomy represent the state-of-the-art surgical procedures in addressing the conductive hearing loss caused by otosclerosis. Their high rates of success and long-term stability have been demonstrated repeatedly in many studies. In comparing the short- and long-term results of the 2 procedures, it is evident that stapedotomy confers better hearing gain at high frequencies and lower complication rates. Modified stapes mobilization procedures may represent the next major development in stapes surgery in a selected patient population...
February 1, 2018: Otolaryngologic Clinics of North America
Niels West, Markus Brand, Søren Foghsgaard, Per Cayé-Thomasen
OBJECTIVE: To report surgical results and complications of cochlear implantation in patients with far-advanced otosclerosis (FAO). MATERIALS AND METHODS: This was a retrospective chart review of surgical results in terms of electrode insertion as well as peri- and postoperative complications. Ten cochlear implantations (CIs) were performed in eight patients with FAO. A prior stapedotomy had been performed in all cases. RESULTS: Full electrode insertion was achieved in nine of the 10 operations (90%) and partial insertion in one operation...
December 2017: Journal of International Advanced Otology
Giuseppe Malafronte
OBJECTIVE: To evaluate whether removal of the stapes head and not the entire stapes superstructure prevents footplate complications. STUDY DESIGN: Prospective study. PATIENTS: One hundred and forty-five patients with otosclerosis were included. Patients were divided into 2 groups as follows: Individuals in group 1 (n = 75) underwent removal of the entire stapes superstructure; individuals in group 2 (n = 70) underwent removal of the stapes head only...
January 1, 2018: Annals of Otology, Rhinology, and Laryngology
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
Omid Moshtaghi, Hossein Mahboubi, Yarah M Haidar, Ronald Sahyouni, Harrison W Lin, Hamid R Djalilian
OBJECTIVE: To describe persistent post-stapedotomy vertigo (PSV) and its treatment using migraine prophylaxis. PATIENTS: A retrospective review of all patients with persistent PSV spanning 10 years at a tertiary academic hospital was performed. Patients who experienced persistent vertigo for a minimum of 3 months after surgery were included. Those with possible perilymph fistula, long prosthesis, and benign paroxysmal positional vertigo were excluded. INTERVENTIONS: All patients received instructions on migraine dietary and lifestyle changes and Vitamin B2 and magnesium...
December 2017: Otology & Neurotology
Uwe Schönfeld, Hu Weiming, Veit M Hofmann, Sergije Jovanovic, Andreas E Albers
Total laser energy in CO2 stapedotomy depends on the laser settings and the amount of applications. It is unclear if the amount of total laser energy affects bone-conduction hearing thresholds and if possible effects are temporary or permanent. Alterations of bone-conduction hearing thresholds after single or multiple-shot CO2 laser stapedotomy were analyzed between 1 and 3 weeks and 1.5-6 months after primary (n = 501) or revision surgeries (n = 153) and correlated to time, laser energy, frequency, surgical technique, and pathology encountered in revision stapedotomy...
December 2017: European Archives of Oto-rhino-laryngology
Kinga Harmat, Gergely Thurén, László Simon, Nelli Nepp, Adrienn Németh, Imre Gerlinger, Péter Bakó
INTRODUCTION AND AIM: The reason of gradually developing conductive hearing loss in otosclerotic patients is the ossification of the stapes footplate to the surrounding bony structures and the therapy of stapes fixation is mainly surgical. In stapedotomy the footplate of the stapes is fenestrated with laser and microdrill in a diameter of 0.8 mm, whereas in stapedectomy there is complete removal of the footplate followed by the reconstruction of the ossicular chain. In the early postoperative period, temporary vertigo is frequently recorded which significantly influences the recovery...
September 2017: Orvosi Hetilap
Saad Elzayat, Ahmed Younes, Ayman Fouad, Fatthe Erfan, Ali Mahrous
OBJECTIVE: To evaluate early hearing outcomes using glass ionomer cement to fix the Teflon piston prosthesis onto the long process of incus to minimize residual conductive hearing loss after stapedotomy. STUDY DESIGN: Original report of prospective randomized control study. SETTING: Tertiary referral center. PATIENTS: A total of 80 consecutive patients with otosclerosis were randomized into two groups. Group A is a control group in which 40 patients underwent small fenestra stapedotomy using the classic technique...
October 2017: Otology & Neurotology
Nabil Faranesh, Ebrahim Magamseh, Suliman Zaaroura, Reem Zeidan, Avi Shupak
OBJECTIVE: To compare the hearing and otoacoustic emissions (OAE) outcome of stapedotomy employing 0.4 and 0.6 mm diameter prostheses. MATERIALS AND METHODS: In total, 18 patients with otosclerosis participated in a prospective, double-armed, randomized cohort study. All the patients underwent small fenestra drill stapedotomy employing the Causse fluroplastic large loop piston prostheses. The patients were randomly assigned to groups of 0.4 mm (n=9) and 0.6 mm (n=9) diameter prostheses...
August 2017: Journal of International Advanced Otology
Mun Young Chang, Hyun Seok Choi, Sang-Youp Lee, Ja-Won Koo
BACKGROUND AND OBJECTIVES: A free-beam-type CO2 laser, which use a micromanipulator mounted on a microscope as the delivery system, has the merit of not being affected by hand tremor at the time of shooting. However, this delivery system has several disadvantages, including a restricted operation range and a risk of incorrect focusing. A fiber-type CO2 laser uses a hand-held delivery system and has the opposite merits and demerits. We compared the results of stapes surgery with free-beam and fiber type delivery systems...
July 2017: Journal of Audiology & Otology
Chenkai Dai, Mohamed Lehar, Daniel Q Sun, Lani Swarthout Rvt, John P Carey, Tim MacLachlan, Doug Brough, Hinrich Staecker, Alexandra M Della Santina, Timothy E Hullar, Charles C Della Santina
Sensorineural losses of hearing and vestibular sensation due to hair cell dysfunction are among the most common disabilities. Recent preclinical research demonstrates that treatment of the inner ear with a variety of compounds, including gene therapy agents, may elicit regeneration and/or repair of hair cells in animals exposed to ototoxic medications or other insults to the inner ear. Delivery of gene therapy may also offer a means for treatment of hereditary hearing loss. However, injection of a fluid volume sufficient to deliver an adequate dose of a pharmacologic agent could, in theory, cause inner ear trauma that compromises functional outcome...
August 2017: Journal of the Association for Research in Otolaryngology: JARO
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
Thadé Pieter Marie Goderie, Waiel Hussain Fadhlallah Alkhateeb, Conrad Frits Smit, Erik Frans Hensen
OBJECTIVE: To evaluate the outcome and per- and postoperative complications of the surgical management of patients with a persistent stapedial artery (PSA). METHODS: A systemic literature search for reports on patients treated for pulsatile tinnitus and/or conductive hearing loss caused by a PSA was conducted of the PubMed and Embase databases using the terms "stapedial" and "artery." Inclusion criteria were adequate description of the intervention and pre- and postoperative signs and symptoms...
July 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
Peter A Benedict, Ling Zhou, Robert Peng, Darius Kohan
OBJECTIVE: To determine the longitudinal effectiveness of the malleus to oval window stapedotomy technique among patients undergoing revision surgery when the incus is unavailable. STUDY DESIGN: Retrospective, case series. METHODS: Charts of 15 patients who underwent 17 malleus attachment stapedotomies performed by a single surgeon from 2000 to 2015 were reviewed. Surgery was ambulatory, transcanal, with laser technique, and under local anesthesia...
May 12, 2017: Laryngoscope
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