Outcome of classical and reversal stapedotomy in otosclerosis (original) (raw)
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Journal of Pharmaceutical Research International
Introduction: In order to treat the symptoms of otosclerosis, various surgical and medical treatments are suggested. Surgical treatments are the choice. This study aimed to determine the incidence of vertigo and its cause in Iran, and the present study focused on this issue. Methods: This was a prospective cohort study carried out on patients with otosclerosis undergoing stapedotomy referred to Rasoul Akram hospital, Tehran during 2017-18. The patients aged below 18 or those who had a history of vertigo were excluded. Diapasonic and audiometric tests were carried out. The follow-ups included the time of admission (the day after surgery) for the presence of vertigo using visual analogue scale and diapasonic tests, one week after surgery using visual analogue scale and diapasonic tests, and one month after surgery using visual analogue scale and audiometry. The data were imported to SPSS v.22 software and analyzed. Results: The surgical complications that occurred after stapedotomy fo...
Failures in stapedotomy for otosclerosis
Otolaryngology - Head and Neck Surgery, 2009
To review the results of 78 revision stapedotomies, determining the causes of failure and the predictors of surgical success. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Seventy-eight operations were performed in a tertiary referral center on 72 patients between 1995 and 2005. Indication for surgery was recurrent or persistent conductive hearing loss.
Functional hearing results in patients with otosclerosis before and after stapedotomy
Medicinski pregled, 2012
Surgical treatment of otosclerosis with stapedotomy leads to the improvement of subjective and objective problems in patients with otosclerosis. A prospective study included patients who had been treated surgically at the Department for Ear, Nose and Throat in Novi Sad in the period from September 2006 to September 2007. On the basis of the appropriate diagnostic procedures, 33 patients were diagnosed with otosclerosis. Functional hearing was assessed before and after surgery by means of pure tone audiometry. The comparison of functional results before and after surgery revealed no changes in pure tone average of bone conduction threshold (average hearing threshold for hearing range), whereas pure tone average of air conduction and pure tone average of the gap showed statistically significant improvement. The results of this study demonstrated the applicability of stapedotomy as a method for successful management of otosclerosis. This way of examination offers a new perspective on p...
The outcome of stapedotomy in adult patients with clinical otosclerosis in Erbil
Zanco Journal of Medical Sciences, 2019
Introduction Otosclerosis is defined as a continuous process of bone remodeling in which there is an alteration in bone metabolism of the ottic capsule in the form of bone resorption and re-deposition. Unlike other similar bone diseases, it does not occur outside of the temporal bone. The formation of centers of newly constructed bone, usually occurs in the area of the oval window and annular ligament, leading to stapes fixation. 1 Otosclerosis was first described by Vasalva in 1735 as ankylosis of the stapes to the margins of the oval window. 2 It is well known that otosclerosis has clinical and histological forms. The clinical form of otosclerosis refers to the presence of symptoms like hearing loss and tinnitus. While the histological form the disease is present without symptoms. Histologically demonstrated that otosclerosis is about ten times more common than clinical otosclerosis. 3 The overall incidence of otosclerosis reveals the variability in distribution according to race, gender, geographic location, familial incidence, pregnancy, and age. The disease occurs more frequently in the Caucasian race (white race) than in other races. 4,5 It is less common in Asians and rare in Africans. There has been an increasing incidence of otosclerosis in Japan. 6 Otosclerosis process usually affects young adults and people between 15 and 45 years of age. 7 The incidence of otosclerosis described in the literature ranges between 0.3 and 2%. Souza et al. 8 indicated that clinical otosclerosis is present in 0.5% to 1.0% of the population. In 2001, Declau et al. 9 stated that clinical otosclerosis has a prevalence of 0.3% to 0.4% among the white ethnic population. A recent Jordanian Background and objective: Otosclerosis is a primary disease of the temporal bone that leads to stapes fixation. Hearing loss and tinnitus are the main symptoms. Treatment includes surgery, medical treatment, and sound amplification therapy alone or in combination. This study aimed to evaluate the functional outcomes of patients with clinical diagnosis of otosclerosis undergoing primary stapes surgery in Erbil city. Methods: A retrospective descriptive study. A total of 32 patients with clinical otosclerosis underwent unilateral stapedotomy in the specialized center between September 2011 and September 2013. These included 20 females and 12 males, aged 21 to 48 years, their mean age (±SD) was 31.9 (±10.91) years. Results: The average preoperative and postoperative air conduction threshold was 51.13 and 23.91 dB, respectively. The mean preoperative and postoperative bone conduction threshold was 21.53 and 16.21dB, respectively. The average preoperative and postoperative air-bone gap was 29.03 and 8.51 dB, respectively. All 32 ears (100%) had a residual air-bone gap <10 dB. Conclusion: Stapes surgery showed significant functional hearing outcomes in this study. The very significant reduction in the air-bone gap is a good indicator of the success of the surgery.
Annals of Saudi medicine
Otosclerosis is a common cause of progressive hearing impairment that causes fixation of the stapes. Surgical intervention is the preferred treatment approach to ameliorate the conductive hearing loss associated with stapedial otosclerosis. However, given that it is a difficult and delicate procedure, the surgery may fail for a number of reasons. Therefore, it is very important to evaluate the success rate of the surgical approach used in each regional center. To examine the effectiveness of stapedotomy in improving hearing sensitivity for otosclerotic patients at King Abdul Aziz University Hospital in Riyadh. Retrospective chart review with an analysis of pre- and postoperative surgical treatment. Tertiary referral otolaryngology clinic. All cases who underwent stapedotomy between 1997 and 2009 were retrospectively reviewed. Preoperative and postoperative audiometric assessments were conducted using conventional pure tone audiometry. Differences were analyzed by two-way repeated me...
Clinical Otolaryngology and Allied Sciences, 1998
This study reports the evaluation of the results of 79 stapedotomies in patients with bilateral otosclerosis[ All pre! and postoperative audiological data\ together with all relevant information of the operations\ were stored in a database and analysed retrospectively[ A new approach has been developed in order to evaluate the bene_t of second ear stapes surgery in a more disability!orientated way using the AMA! criteria in the Guides to the Evaluation of Permanent Impairment[ In all patients the percentage of Binaural Hearing Impairment "BHI# and the percentage of Impairment of the Whole Person "IWP# were determined according to the AMA!criteria[ In patients who had both operations at the Academic Medical Centre it was found after the _rst operation that there was an important decrease in the BHI!percentage "from 15) to 09)# as well as for the IWP!percentage "from 8) to 3)#[ In addition\ the percentages dropped signi_cantly after the second operation "from 00) to 6) and from 3) to 1)\ respectively#[ During follow!up there were no serious complications[ It is concluded that bilateral stapedotomy is a safe procedure with good results[ Keywords audiometry otosclerosis second ear stapedectomy
Very far-advanced otosclerosis: stapedotomy or cochlear implantation
Acta Oto-laryngologica, 2007
Conclusion. Every patient with severe or profound hearing loss must have a temporal bone high-resolution computed tomography (CT) scan. Stapedotomy is a simple, safe and low-cost procedure compared with cochlear implantation and can provide very good results. This can justify our decision to propose stapedotomy at the initial treatment in patients with very far-advanced otosclerosis. In cases of hearing failure after stapes surgery, cochlear implantation is an option. Objective. This study aimed to find the best first intention treatment of very far-advanced otosclerosis. Materials and methods. This was a retrospective study and included 14 patients with non-measurable preoperative bone and air conduction thresholds and otosclerosis on temporal bone high-resolution CT scan. Stapes surgery followed by a well fitted hearing aid was the initial treatment in 11 patients and cochlear implantation in 7 patients, including 4 patients who had poor results after stapedotomy. Objective and subjective audiometric results were studied and compared between stapedotomy and cochlear implantation groups. Results. Objective and subjective results were statistically better in the cochlear implant group than in the stapedotomy group. However, four patients in the stapedotomy group had comparable results to the patients with cochlear implants.
Audiometric Results of Stapedotomy Surgery for Otoscelorsis
Otology & Neurotology, 2019
Background: The objective of this study was to identify a correlation between the radiological stage of otosclerosis and the pre-and postoperative audiometric results of patients who underwent a stapedotomy. Methods: Ninety-three patients with radiologically and surgically confirmed otosclerosis who underwent stapedotomy surgery and CT scanning within 18 months before the operation were included. The CT scans were interpreted by an otologist and a specialised radiologist to determine their radiological stage according to the classification of Veillon and Fraysse. The patients received a pre-and postoperative audiogram in the short and long term. Results: The preoperative bone conduction thresholds were higher in patients who presented with an advanced radiological stage of otosclerosis: 32.7 dB AE 12.4 compared with those who presented with a less advanced radiological stage: 24.3 dB AE 10.0. The preoperative air conduction thresholds were higher in patients who presented with an impairment of the round window: 58.1 dB AE 13.5 compared with those who presented with no impairment of the round window: 48.7 dB AE 14.5. The postoperative improvement in the airbone gap was significantly higher for the localised foci: 16.9 dB AE 8.6 versus 11.0 dB AE 9.2, but only in the short term. Conclusion: There was a clinical radiological correlation with the preoperative results: In BC, there was a correlation with the radiological stage of Veillon and in AC, there was a correlation with impairment of the round window. The link between the radiological stage of otosclerosis and the postoperative audiometric results is less obvious. In the short term, the audiometric improvements in the air-bone gap were greater in patients in the early stages according to the Veillon classification, but this result was not sustained in the long-term.
Audiological Outcomes of Stapedotomy: Our Experience
Nepalese Journal of ENT Head and Neck Surgery, 2018
Objective: This study was aimed to sequentially document the patient’s audiological improvement after stapedotomy as measured by pure tone audiometry.Material and Methods: This prospective clinical study was performed in a total of 100 patients (age range: 20 – 63 years), diagnosed with Otosclerosis who underwent Stapedotomy at the Department of Otology, Madras ENT Research Foundation, Chennai between September 2010 to March 2012. Pre-operative and Post-operative audiometric evaluation was done using the same conventional pure tone audiometer with standard calibrations. Post-operative audiometry was sequentially performed at 6 months, 1 year and 2 years. Bone-conduction and air conduction thresholds and the Air-bone gap (ABG), were assessed at each schedule at 0.5 KHz, 1 KHz, 2 KHz and 4 KHz frequencies respectively.Result: All patients had significant audiological improvement as measured by their sequential pure tone audiometries. Overall, the frequency specific pre-operative mean ...
Stapedotomy and its effect on hearing – our experience with 54 cases
African Health Sciences, 2016
Introduction: This study reviews the cases of stapedotomy and evaluates its effectiveness at improving hearing loss in patients with otosclerosis. Materials and methods: Retrospective review of patients' records who had clinical and audiometric diagnosis of otosclerosis from January to December 2012 Results: A total of 54 stapedotomy surgeries (52 unilateral and 1 bilateral surgeries) were received. Average post-operative ABG for 0.5, 1, 2 and 4 KHz showed that 61.1% had complete closure of ABG (ABG < 10 dB) compared with 1.6% preoperatively and 85.2% had closure of ABG to within 20dB compared with 4.7% preoperatively (t-13.89, p = 0.000). More than 94% had hearing improvement and 81.5% had ABG closure greater than 10 dB postoperatively (mean gain 23.38 ± 12.37, t = 13.89, p = 0.000). A total of 13% complications were recorded with TM perforation (5.6%) being the commonest complication. Conclusion: Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patients' quality of life. A favorable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and appropriate surgical technique.