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Advanced otosclerosis

Henry Zhang, Phui Yee Wong, Tiarnan Magos, Jabin Thaj, Gaurav Kumar
The advent of the endoscope has facilitated otological surgery in recent years. Advances in optical technology have led to the development of high definition visualisation, such as 4K magnification. Narrow band imaging (NBI) has been shown to improve visualisation of tissue based on varying degrees of vascularity. This is a feasibility study, the first of its kind, aiming to investigate the appearances of middle ear anatomy and pathology (tympanic membrane, tympanosclerosis, cholesteatoma, granulation, endolymphatic sac hydrops, otosclerosis) under the NBI filter, using a high definition 4K endoscope...
January 2018: European Archives of Oto-rhino-laryngology
C Heining, R Banga, R Irving, C Coulson, P Monksfield
BACKGROUND: Patients with advanced otosclerosis can present with hearing thresholds eligible for cochlear implantation. This study sought to address whether stapes surgery in this patient group provides a clinically significant audiological benefit. OBJECTIVES: To assess pre- and post-operative hearing outcomes of patients with advanced otosclerosis, and to determine what proportion of these patients required further surgery including cochlear implantation. METHODS: Between 2002 and 2015, 252 patients underwent primary stapes surgery at our institution...
September 6, 2017: Journal of Laryngology and Otology
Todd Kanzara, Jagdeep Singh Virk
AIM: To determine the sensitivity and specificity of high resolution computed tomography (HRCT) in the diagnosis of otosclerosis. METHODS: A systematic literature review was undertaken to include Level I-III studies (Oxford Centre for Evidenced based Medicine) that utilised HRCT to detect histology confirmed otosclerosis. Quantitative synthesis was then performed. RESULTS: Based on available level III literature, HRCT has a relatively low sensitivity of 58% (95%CI: 49...
July 16, 2017: World Journal of Clinical Cases
Jay Burmeister, Susan Rathgeb, Jacques Herzog
OBJECTIVE: To evaluate outcomes of cochlear implantation of patients with otosclerosis of the otic capsule. STUDY DESIGN: A retrospective case series of 6 patients (7 ears). PATIENTS: 6 patients (7 ears), 5 patients with severe to profound sensorineural hearing loss; 1 patient with mild to profound sensorineural hearing loss, with radiologic evidence of otosclerosis. All patients were adult males, with or without history of stapes surgery...
September 2017: American Journal of Otolaryngology
Pádraig Thomas Kitterick, Guna Reddy-Kolanu, David Baguley, Jeremey Lavy, Peter Monksfield, Rupan Banga, Jaydip Ray, Ad Snik, Gerard M O'Donoghue
HYPOTHESIS: Assess the clinical acceptability of direct acoustic cochlear implantation for patients with advanced otosclerosis and the support for conducting a controlled trial of its effectiveness in the United Kingdom. BACKGROUND: Emerging evidence supports the efficacy of direct acoustic cochlear implantation in patients with advanced otosclerosis whose needs cannot be managed using the combination of stapes surgery and hearing aids. A controlled trial would provide evidence for its effectiveness and cost-effectiveness to healthcare commissioners...
August 2017: Otology & Neurotology
Lora Batson, Denise Rizzolo
Otosclerosis is a complex and progressive disease of pathological bone remodeling that affects the otic capsule of the temporal bone, resulting in hearing loss. Although traditional diagnostic methods are still used, improvements in technology and research have paved the way for additional diagnostic techniques and advancements. The traditional treatment of otosclerosis, stapes surgery, is now being augmented or replaced by innovations in hearing aid technology and cochlear implants. Earlier diagnosis of otosclerosis can occur through understanding of the cause, risk factors, and current diagnostic testing...
February 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
İsmail Yılmaz, M Volkan Akdoğan, Fulya Özer, Haluk Yavuz, Cabbar Çadırcı, Levent N N Özlüoğlu
In this article, we present four patients who underwent cochlear implantation due to far advanced otosclerosis. Preoperative evaluations, intraoperative findings, complications, and postoperative benefits were analyzed. Cochlear implantation is a treatment option providing excellent audiological results for rehabilitation of patients with far advanced otosclerosis. However, facial nerve stimulation after cochlear implantation is observed more frequently in patients with otosclerosis. Also, caution should be paid in patients with otosclerosis in terms of cochlear ossification and inconsistent results...
November 2016: Kulak Burun Boğaz Ihtisas Dergisi: KBB, Journal of Ear, Nose, and Throat
Yasin Abdurehim, Alexandre Lehmann, Anthony G Zeitouni
OBJECTIVES: To compare the hearing outcomes of stapedotomy vs cochlear implantation in patients with advanced otosclerosis. DATA SOURCES: PubMed, EMBASE, and The Cochrane Library were searched for the terms otosclerosis, stapedotomy, and cochlear implantation and their synonyms with no language restrictions up to March 10, 2015. METHODS: Studies comparing the hearing outcomes of stapedotomy with cochlear implantation and studies comparing the hearing outcomes of primary cochlear implantation with salvage cochlear implantation after an unsuccessful stapedotomy in patients with advanced otosclerosis were included...
November 2016: Otolaryngology—Head and Neck Surgery
Daniele Marchioni, Davide Soloperto, Luca Bianconi, Maria C Guarnaccia, Elisabetta Genovese, Livio Presutti
HYPOTHESIS: Ossification of the cochlea was once considered to be a contraindication for cochlear implantation. Advances in cochlear implant technology and coding strategies have led to developments in different surgical procedures to manage cochlear ossification. The endoscopic technique allows a direct approach to the round window and the cochlea, especially in remodeled labyrinth, allowing a better vision of scala tympani. BACKGROUND: Tertiary referral ENT center...
October 2016: Auris, Nasus, Larynx
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
Khaled M Krisht, Clough Shelton, William T Couldwell
Julius Lempert (1891-1968) was one of the most revolutionary and innovative neuro-otologists of the 20th century. He had a remarkable role in advancing the field of otolaryngology to its modern shape and form, especially through his groundbreaking introduction of the fenestration procedure for the treatment of otosclerosis. Although he is highly celebrated by many neuro-otologists for his contributions to our surgical and anatomical understanding of the petrous bone, he is not well known to the neurosurgical community...
March 2015: Journal of Neurological Surgery. Part B, Skull Base
Bilal Kabbara, Clement Gauche, Marie-Noelle Calmels, Benoit Lepage, Bernard Escude, Olivier Deguine, Bernard Fraysse, Mathieu Marx
OBJECTIVES: To describe the hearing outcomes in patients with far-advanced otosclerosis and to identify the best initial approach based on preoperative word recognition scores (WRS), pure tone averages (PTA), and radiological classification. STUDY DESIGN: Retrospective case review. SETTING: Academic neurotology tertiary referral center. PATIENTS: All patients (n = 58) with preoperative air conduction PTA less than 85 dB (HL), disyllabic WRS less than or equal to 50% at 60 dB (HL) with well-fitted hearing aids, and evidence of otosclerosis on CT scan, treated in our department over the past 20 years...
March 2015: Otology & Neurotology
Maarten C van Loon, Paul Merkus, Conrad F Smit, Cas Smits, Birgit I Witte, Erik F Hensen
OBJECTIVE: To evaluate the effect of stapedotomy in cochlear implant candidates with far-advanced otosclerosis (FAO). DESIGN: Systematic review of literature and meta-analysis. DATA SOURCES: PubMed, EMBASE, and Cochrane databases were searched for "stapedotomy" and "far-advanced otosclerosis" and their synonyms. The search was carried out on November 28, 2013; no language restrictions were applied. STUDY SELECTION: The initial search yielded 243 articles; a total of nine articles met our inclusion criteria (i...
December 2014: Otology & Neurotology
L A Kulakova, E P Poliakova, I V Bodrova, A S Lopatin
The objective of the present study was to evaluate the effectiveness of the surgical treatment of otosclerosis in the subjects of advanced age. The medical histories of 19 patients aged above 65 years (20 ears) presenting with otosclerosis were available for the retrospective analysis. All of them had undergone surgical interventions (a total of 22 ones or 4.49% of the 489 operations performed between 2001 and 2012). The audiometric assessment was made at four wavelengths (0.5, 1, 2, and 4 kHz). Primary surgery (n=18) was preceded by the determination of the high air and bone conductivity thresholds (76...
2014: Vestnik Otorinolaringologii
T Lenarz, B Schwab, H Maier, E Kludt
OBJECTIVE: Implantable hearing aids have become a valid option for the therapy of various forms of hearing loss. The Codacs™ Direct Acoustic Cochlear Implant System is the first vibratory implant available for patients with severe to profound mixed hearing loss (MHL). By directly coupling sound energy into the perilymph, a very high maximum power output (MPO) is achieved over a broad frequency range. Via a conventional stapedotomy, the vibratory energy of the electromagnetic actuator is transferred directly to the perilymph through the oval window...
July 2014: HNO
Felipe Castillo, Rubén Polo, Auxiliadora Gutiérrez, Pablo Reyes, Ana Royuela, Antonio Alonso
INTRODUCTION: Several studies support the use of cochlear implants (CI) in far-advanced otosclerosis (FAO). MATERIAL AND METHODS: We compared our results of CI in patients with FAO and unknown origin hearing loss (UOHL) and our incidence of facial electrical stimulation and difficult insertion of the electrode bundle up to 3 to 5 years from surgery. RESULTS: We found 17 patients with CI in FAO and UOHL. FAO patients achieved better results on the pure tone average (PTA) and recognition of monosyllables by GEE test (p=0...
September 2014: American Journal of Otolaryngology
Maureen Loewenthal, Nathan Jowett, Chia-Jung Busch, Rainald Knecht, Carsten V Dalchow
Advances in operative technique, instrumentation, and prosthesis design in otosclerosis surgery continue since Shea performed the first successful surgery. This is the first analysis to specifically compare post-operative hearing outcomes following stapedotomy surgery performed under local versus general anesthesia. Hearing outcomes were further stratified by comparing conventional perforator and Er:YAG laser ablation perforation techniques. Pre- and post-operative audiograms were retrospectively analyzed together with the method of anesthesia and the perforation technique for all patients with otosclerosis who underwent stapedotomy between 1998 and 2007...
September 2015: European Archives of Oto-rhino-laryngology
Thomas Lenarz, Nicolas Verhaert, Christian Desloovere, Jolien Desmet, Christiane D'hondt, Juan Carlos Falcón González, Eugen Kludt, Angel Ramos Macías, Henryk Skarżyński, Paul Van de Heyning, Caroline Vyncke, Arkadiusz Wasowski
The aim of this study was to investigate the efficacy of a direct acoustic cochlear implant (DACI) for speech understanding in noise in patients suffering from severe to profound mixed hearing loss (MHL) due to various etiologies compared to the preoperative best-aided condition. The study was performed at five tertiary referral centers in Europe (Belgium, Germany, Poland and Spain). Nineteen adult subjects with severe to profound MHL due to (advanced) otosclerosis, ear canal fibrosis, chronic otitis media, tympanosclerosis or previous cholesteatoma were implanted with a DACI (Codacs™ Investigational Device) combined with a conventional stapes prosthesis...
2014: Audiology & Neuro-otology
Gokhan Kutlar, Mehmet Koyuncu, Muzaffer Elmali, Figen Basar, Sinan Atmaca
The objective of the study was to investigate the relationship between extent of otosclerotic foci and audiological findings in otosclerotic patients with mixed hearing loss using high-resolution computed tomography (HRCT) and also to measure the density of bony labyrinth in otosclerotic patients and compared with control group. This was a retrospective study. Twenty-five patients with clinical otosclerosis and mixed hearing loss were included in the study. The average threshold of air-bone conductions (AC, BC) within the 0...
September 2014: European Archives of Oto-rhino-laryngology
Mohammad Seyyedi, Barbara S Herrmann, Donald K Eddington, Joseph B Nadol
HYPOTHESIS: Unintentional electrical stimulation of the facial nerve by cochlear implants occurs when advanced otosclerosis invades the endosteum of both the upper basal turn of the cochlea (UBTC) and the facial nerve canal (FNC) and all the bone between these 2 structures. BACKGROUND: A complication of cochlear implantation is facial nerve stimulation (FNS) known to be more common in otosclerosis. Otosclerotic involvement of the enchondral bone of the otic capsule results in areas of bone resorption, new bone formation, vascular proliferation, and a connective tissue stroma...
December 2013: Otology & Neurotology
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