Evaluation of Functional Outcomes after Stapes Surgery in Patients with Clinical Otosclerosis in a Teaching Institution

Introduction Otosclerosis is a primary disease of the temporal bone that leads to stapes ankylosis. Hearing loss is the main symptom. Treatment includes surgery, medical treatment, and sound amplification therapy alone or in combination. Objective To evaluate the functional outcomes of patients with clinical diagnosis of otosclerosis undergoing primary stapes surgery in a teaching institution. Method Retrospective descriptive study. Results A total of 210 ears of 163 patients underwent stapes surgery. Of the 163 patients, 116 (71.2%) underwent unilateral surgery and 47 (28.8%) underwent bilateral surgery. Six of the 210 operated ears had obliterative otosclerosis. The average preoperative and postoperative air-bone gap was 32.06 and 4.39 dB, respectively. The mean preoperative and postoperative bone conduction threshold was 23.17 and 19.82 dB, respectively. A total of 184 (87.6%) ears had a residual air-bone gap <10 dB, and 196 (93.3%) had a residual air-bone gap ±15 dB. Two patients (0.95%) had severe sensorineural hearing loss. Conclusion Stapes surgery showed excellent functional hearing outcomes in this study. This surgerymay be performed in educational institutions with the supervision of experienced surgeons.

Effectiveness of Stapes Mobilization in Tympanosclerotic Stapes Fixation

BACKGROUND AND OBJECTIVES: Tympanosclerosis is a nonspecific and irreversible result of chronic inflammation or infection of the middle ear. However, there remains disagreement about how best to surgically treat tympanosclerotic ossicular fixation, with the controversy over its management when stapes is involved. The aim of this study was to evaluate operative findings and hearing results of tympanosclerosis involving the ossicular chain, which in turn would establish better surgical treatment of tympanosclerotic ossicular fixation. SUBJECTS AND METHODS: In this prospective study conducted from Mar 2000 to Dec 2007, 38 patients with tympanosclerosis who had undergone surgical treatment were evaluated. The clinical and operational records and pre- and postoperative pure tone audiograms were reviewed. RESULTS: Operative findings showed stapes fixation is the most common. In 8 patients (21.1%), stapes was mobile, while, in the remaining 30 patients (78.9%), stapes fixation was found. In all cases with stapes fixation, stapes mobilization was possible. Following hearing result reporting guideline by the Korean Otological Society, the success rate of middle ear surgery was 68.4% (26 of 38 patients). In cases with stapes fixation, the success rate was 66.6% (20 of 30 patients), while, in cases with no stapes fixation, the success rate was 75.0% (6 of 8 patients). However, there was no statistical significance between the two groups. CONCLUSION: Stapes fixation was found in 78.9% of tympanosclerotic ossicular fixation. In management of tympanosclerotic stapes fixation, meticulous excision of tympanosclerotic plaques and removal of new bone formation around stapes footplate after adequate exposure could achieve a relatively good hearing result without stapes surgery.

Effects of ossicular reconstruction with partial ossicular replacement prosthesis in patients with tympanosclerosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of ossicular reconstruction with partial ossicular replacement prosthesis (PORP) in patients with tympanosclerosis.</p><p><b>METHODS</b>The data of 28 cases of tympanosclerosis treated between 1992 and 2006 were reviewed. Of the 28 patients, 14 (14 ears) underwent ossicular reconstruction with PORP and 14 (14 ears) had ossicular mobilization, and all the patients were followed-up for 3-24 months.</p><p><b>RESULTS</b>Significant improvement was found in postoperative speech frequency (500, 1000, 2000 Hz) pure tone average (PTA) and air-bone gap (ABG) closure after in the operation the two groups. Ossicular reconstruction using PORP resulted in statistically better ABG closure and PTA (P<0.05).</p><p><b>CONCLUSION</b>In ossicular attic fixation, ossicular reconstruction using PORP can yield better results than mobilization of the major ossicles in patients with tympanosclerosis.</p>

Un método simple para verificar la movilidad del estribo en los oídos perforados / A simple method to verify the stapes mobility in perforated ears

Los autores muestran un método sencillo y útil para verificar la movilidad del estribo, cuando éste es visible sea a través de una perforación o de una membrana timpánica muy adelgazada. Para ello utilizan una fuente sonora metálica que es golpeada con intensidad cerca del oído sano del paciente con lo que se produce el reflejo acústico y, dado que su eferencia es bilateral, puede observarse bajo el microscopio el movimiento del estribo