Surgical and medical treatment of hearing loss in mixed otosclerosis.

OBJECTIVES: We assessed the effect of using preoperative sodium fluoride (NaF) on the difficulty of working with the footplate during stapedectomy and its effect on the postsurgical hearing gain in patients with mixed otosclerosis (i.e., otosclerosis and/or otospongiosis). METHODS: There were 2 groups of patients with mixed otosclerosis. The experimental group was made up of patients with an active focus of the disease; they received NaF for 6 months and then underwent stapedectomy. The control group was made up of patients with an inactive focus of the disease; they underwent stapedectomy without administration of NaF. RESULTS: The difference between the study groups in the degree of difficulty in extracting the footplate was not found to be statistically significant. Both groups had hearing gains in bone and air conduction. The level of posttreatment hearing gain in the group exposed to NaF was greater than that in the nonexposed group. CONCLUSIONS: Sodium fluoride administered to patients with mixed otosclerosis and an active focus of disease does not increase the difficulty of working with the footplate during stapedectomy, and it increases the hearing gain after the procedure.

Resultados audiológicos comparando prótesis de teflón versus prótesis alambre/teflón tipo Shucknecht / Auditory results used to compare a teflón prótesis vs a Schucknecht type wire/Teflón prótesis

Objetivo. Determinar los resultados audiológicos, comparando prótesis de teflón (Fluoroplastic) con prótesis tipo pistón de alambre/teflón post-estapedectomía. Material y métodos: Realizamos un ensayo clínico controlado aleatorizado ciego simple de junio de 2003 a agosto de 2004 en el Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello, de la Unidad médica de alta especialidad, Hospital General Centro Médico Nacional "La Raza", México D.F. El grupo de estudio se formó con aquellos pacientes en quienes se colocó prótesis de teflón (Fluoroplastic) y el grupo control con prótesis tipo Schucknecht con pistón de alambre/teflón. Se realizó valoración audiológica pre y post-quirúrgica en el servicio de Audiología y Otoneurología del mismo Hospital utilizando un audiómetro marca Madzen Minimate 602, de donde se obtuvo el promedio de la vía aérea en frecuencias bajas, medias, altas, el diferencial aéreo/ ósea por frecuencias y total. Los resultados fueron analizados utilizando el paquete estadístico SPSS 8.0. Resultados: Se estudiaron 138 pacientes: 68 para el grupo de estudio (prótesis de Fluoroplastic) y 70 para el grupo control (prótesis de alambre/teflón); se obtuvo una diferencia estadísticamente significativa entre grupos (p< 0,04) de acuerdo a U de Mann-Whitney. El cierre del diferencial aéreo/ósea, mostró una diferencia estadísticamente significativa (p< 0,001) en frecuencias bajas y altas para el grupo de estudio

Purpose: To compare aTeflon prosthesis to a piston- type wire/Teflon prosthesis assessing auditory results post – Stapedectomy. Material and methods: We conducted a randomized controlled blinded clinical study from June 2003 to August 2004 at the Otorhinolaryngology, and Head and Neck Surgical Wards at the highly specialized medical unit of “La Raza” General Hospital National Medical Center in Mexico City. The study group was comprised by patients receiving a Teflon prosthesis (Fluoroplastic piston), while the control group received a Schuckneckt type piston wire/Teflon prosthesis. A pre- and post-auditory assessment was done obtaining the average at low, medium and high airway frequencies, the air/bone frequency differences and the total, at the Audiology and Otoneurology Service at the same hospital using a Madzen Minimate 602 brand audiometer. The results were analyzed using SPSS statistical software version 8.0. Results: 138 patients were studied: 68 were included in the study group (Fluoroplastic prosthesis) and 70 in the control group (wire/Teflon prosthesis). A statistically significant difference was found between the groups (p < 0.04) according to the Mann-Whitney U test. The air/bone closure difference was statistically significant (p < 0.001) at low and high frequency ranges for the study group

Poststapedectomy hearing gain: comparison of a Teflon (fluoroplastic ASTM F 754) prosthesis with a Schuknecht-type wire/Teflon prosthesis.

We conducted a retrospective study to compare poststapedectomy hearing gain in study-eligible patients who had received a Teflon (fluoroplastic ASTM F 754) prosthesis (study group; n = 76) with hearing gain achieved in a matched group (by age, sex, and degree of hypoacusis) of patients who had received a Schuknecht-type wire/Teflon prosthesis (control group; n = 70). All procedures had been performed by the authors at our institution between Jan. 2, 1994, and Dec. 31, 1997. Airway averages at low, medium, and high frequencies were estimated on the basis ofpre- and postoperative audiologic evaluations, as were total air-bone gaps at 7 frequencies between 125 and 8, 000 Hz. We found that the study group achieved a significantly greater degree of hearing gain at 125 and 250 Hz and significantly better closure of the air-bone gap at 250, 500, 1,000, 2,000, and 4,000 Hz. The hearing outcomes among patients in the study group were excellent.