No abstract

No abstract

No abstract

The incidence and the severity of early voice and swallowing postthyroidectomy symptoms are significantly reduced in patients who undergo VAT compared with conventional surgery.

Early voice therapy may enable significant improvement in vocal function, allowing the patient to avoid surgery.

No abstract

Objective: To evaluate the functional results obtained after stapedotomy in patients affected by otosclerosis, according to the prosthesis diameter. Patients and Methods: A retrospective case review was performed. Two hundred and twelve consecutive ears in 132 patients affected by otosclerosis were operated on. All patients underwent primary small-fenestra stapedotomy. In 112 of the 212 stapedotomies (52.83%) the 0.6-mm piston (group A) and in 100 of the 212 stapedotomies (47.16%) the 0.4-mm piston (group B) were employed. Results: After surgery, the difference between the two groups in the air conduction improvement (21.04 dB group A vs. 11.14 dB group B) reached statistical significance (p < 0.05). In group A, the postoperative air conduction pure-tone average improvement obtained at 0.5, 1, and 2 kHz was statistically greater as compared with group B (p < 0.05). In group A the postoperative bone conduction pure-tone average decreased by 5.19 dB, whereas in group B it increased by 2.95 dB (p > 0.05). The incidence of ears with a postoperative bone conduction worsening >10 dB (sensorineural hearing loss) was lower in group B than in group A: 5 of 100 ears (5%) versus 9 of112 ears (8.03%) (p > 0.05). The postoperative air-bone gap was smaller in group A than in group B for all frequencies, but the difference can be considered significant at 1 and 2 kHz. The air-bone gap improvement in group A if compared with group B was statistically greater at 0.5, 1, and 2 kHz (p < 0.05). Conclusions: Our study suggests that an increase in piston diameter gives better results, especially at lower frequencies. The functional results obtained after stapedotomy confirm the advantageous effect of a larger piston diameter on hearing of the speech frequencies and support the opinion of a better clinical effect.

Objective: To analyze and compare the preoperative factors that potentially influence the outcome of stapedotomy in our study group. Materials and Methods: 161 cases were enrolled. Clinical variables considered to influence functional results – air conduction (AC) and bone conduction (BC) pure-tone average (PTA), air-bone gaps (ABG), sensorineural hearing loss (SNHL), ABG gain and ΔSNHL – were gender, age, case type (unilateral vs. bilateral), ear side (right vs. left), pregnancy, vascular disease and family history of otosclerosis. The audiometric variables were preoperative AC- and BC-PTA, SNHL and ABG. Results: Univariate logistic regression analysis showed that the probability of obtaining a ≥10 dB gain is significantly affected by the following factors: age <50 years, AC-PTA ≥50 dB and preoperative ABG ≥30 dB. All the other factors included into the registration (gender, familiarity, side, bilateral vs. unilateral, pregnancy, vascular diseases and preoperative BC-PTA) were not found to significantly affect postoperative gain (p > 0.05). Nevertheless, multivariate logistic regression analysis maintained a statistically significant correlation only between gain ≥10 dB and both preoperative ABG ≥30 dB and age <50 years. Conclusions: The accurate knowledge of predictive factors is a valuable tool that permits the surgeon to plan surgery with a better case selection as well as assisting in counseling the patient with regard to the likelihood of success of the procedure.