ABSTRACT
Introducción: A pesar de las ventajas de la audición biaural, el manejo quirúrgico del segundo oído en pacientes con otoesclerosis bilateral fue por años un tema controversial debido a su riesgo potencial de hipoacusia sensorioneural. Objetivo: Describir los resultados audiológicos y quirúrgicos en pacientes operados bilateralmente por otoesclerosis en nuestro hospital entre 1988-2011. Material y método: Estudio retrospectivo de 56 pacientes en quienes se realizó cirugía de otoesclerosis en ambos oídos, mediante revisión de fichas clínicas. Resultados: En 13,5 por ciento de 415 pacientes se realizó cirugía bilateral. La edad promedio fue 44,2 +/- 7,7 (hombres) y 42,0 +/- 10,4 años (mujeres). La mejoría de los umbrales auditivos aéreos promedios en la primera y segunda cirugía fue de 33,6y 29,2 dB respectivamente, mientras que la de los umbrales óseos fue de 7,0y 3,0 dB correspondientemente. Las dificultades quirúrgicas para la primera y segunda cirugía fueron, respectivamente: platina flotante 0 por ciento y 2,5° por ciento, platina obliterada 5,4 por ciento y 5,1 por ciento, nicho profundo 5,4 por ciento y 0 por ciento, facial proscidente 38,5 por ciento y 43,2 por ciento, facial dehiscente 18,2 por ciento y 13,8 por ciento y sección de cuerda del tímpano 2 por ciento y 5,7 por ciento. Discusión: Los resultados auditivos del segundo oído son comparables a los de la primera cirugía. Esto, junto a la ausencia de complicaciones significativas, apoya la realización de intervenciones quirúrgicas bilaterales en otoesclerosis. Conclusión: La cirugía del segundo oído en hipoacusia bilateral por otoesclerosis es una alternativa segura y confiable.
Introduction: Despite the advantages of binaural hearing, surgical management of the second ear in patients with bilateral otosclerosis was for years a controversial topic due to the risk of sensorineural hearing loss. Aim: To describe the surgical and audiological results of patients with bilateral surgeries for otosclerosis in our hospital between 1988-2011. Material and method: Retrospective study based on clinical charts revision. Results: 13.5 percent of the 415 patients underwent bilateral surgery. The average age was 44.2 +/- 7.7 (men) and 42.0 +/- 10.4 years (women). There was a 33.6 dB improvement in average air-conduction hearing thresholds in the first surgery and 29.2 dB for the second, while the mean bone-conduction improved 7.0 and 3.0 dB for the first and second surgery correspondingly. The surgical difficulties found in the first and second surgeries were, respectively: floating platens 0 percent and 2.5 percent, obliterated platens 5.4 percent and 5.1 percent, deep niche 5.4 percent and 0 percent, facial overhang 38.5 percent and 43.2 percent, dehiscent facial 18.2 percent and 13.8 percent and chorda tympani section 2 percent and 5.7 percent. Discussion: Hearing results for the second ear were comparable to the first surgery. This, together with the absence of significant complications, supports a bilateral surgical approach. Conclusion: Surgery of the second ear in bilateral hypoacusia due to otosclerosis has proven to be a safe and reliable alternative.
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Stapes Surgery , Otosclerosis/surgery , Otosclerosis/epidemiology , Audiometry, Pure-Tone , Retrospective Studies , Cochlear Implants , Hearing Loss/surgery , Treatment OutcomeABSTRACT
Introduction: Otosclerosis is a disease that produces a conductive hearing loss. It consists of an abnormal bone growth called otospongiosis that develops a stapes fixation. It is a hereditary disease but the specific cause is unknown. Its surgical management has shown good audiometric results and low complication rates. Aim: To describe the clinical experience in our Unit, with bilateral and unilateral surgeries in patients with Otosclerosis. Methods: A retrospective study on clinical charts revision. Results: 415 patients underwent surgery for Otosclerosis. 359 patients had a unilateral procedure and 56 patients had a bilateral surgery (13,5 percent). Mostly women (67,9 percent). There was no difference between the results of both ears. The Average air-conductive hearing improvement in the first surgery was 29,9 +/- 3,4 dB, and in the second surgery was 30,6 +/- 3,4 dB. The most frequent complication was the section of the chorda tympani (2 percent). Discussion: The surgical treatment for Otosclerosis is a safe procedure with excellent audiometrical results and low complication rates. Our results are similar to those in literature. The number of this procedure has increased every year in our institution and we have demonstrated that surgery in both ears is safe with good results.
Subject(s)
Humans , Male , Adult , Female , Middle Aged , Otosclerosis/surgery , Otosclerosis/diagnosis , Otosclerosis/epidemiology , Stapes SurgeryABSTRACT
Otosclerosis is one of the common causes of hearing loss. The incidence varies between 0.1% and 2%. In Lebanon otosclerosis is a common entity that has not been well evaluated. To the best of our knowledge there is no epidemiologic analysis of the incidence or outcomes of otosclerosis in Lebanon. We collected the number of stapedectomies performed for otosclerosis in different hospitals between Jan. 1994 and Dec. 1995. We also retrospectively reviewed the charts of 71 cases who underwent stapedectomy at Hotel-Dieu de France - St Joseph University Hospital Medical Center, Beirut, Lebanon.Between 1992 and 1996 the incidence of otosclerosis in Lebanon as revealed through stapedectomy is 5/100 000.We report also on the pathology, technique, complications and outcomes of stapedectomy surgery for otosclerosis in Hotel-Dieu Hospital. Further epidemiologic studies and screening is required to reveal the exact incidence of this common entity that could be underdiagnosed or untreated in our country