Die Verlagerung des hinteren Steigbügelschenkels. Eine vergessene Methode der Otosklerosechirurgie?

Neumann, Andreas; Hj, Schultz-Coulon

doi:10.1055/s-2001-17834

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…For this explorative retrospective single-center study, 212 surgical cases were identified and were done using the same techniques and standards (18). All surgeries were performed between November 2012 and April 2019.…”

Section: Methodsmentioning

confidence: 99%

Stapes and Stapes Revision Surgery: Preoperative Air-Bone Gap Is a Prognostic Marker

Sharaf

Grueninger

Hilpert

et al. 2021

Otology &Amp; Neurotology

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Objective: Stapes surgery is considered an effective treatment in otosclerosis, but controversy remains regarding predictors of surgical outcome. Study Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: One hundred sixty three cases of stapes surgery between 2012 and 2019 were reviewed. Main Outcome Measures: Primary outcome measures were relative hearing improvement (relHI), defined as preoperative minus postoperative air conduction divided by preoperative air-bone gap (ABG), as well as relative ABG closure (relABGc), defined as preoperative ABG minus postoperative ABG divided by preoperative ABG. Univariate and multivariate linear regression analyses were performed to determine independent predictors for these outcomes. Results: Higher preoperative bone conduction (BC) and primary surgery (compared with revision) were independently associated with increased relHI ( p ¼ 0.001 and p ¼ 0.004, respectively). Lower preoperative BC, higher preoperative ABG, primary surgery, and age were independently associated with increased relABGc ( p ¼ 0.0030, p < 0.001, p ¼ 0.0214, and p ¼ 0.0099, respectively). Sex did not predict surgical outcome. In patients with less than 20 dB preoperative ABG, likelihood of negative relABGc was increased (compared with 20-30 dB or >30 dB preoperative ABG, p ¼ 0.0292, Fisher's exact test). This tendency was not significant for relHI ( p ¼ 0.074). Conclusions: Our findings demonstrate that calculating HI and ABGc in relation to preoperative ABG can reliably predict outcomes of stapes surgery. Both primary and revision stapes surgery are effective treatment options, but relative improvement is higher in primary cases. Preoperative BC, preoperative ABG, and age predict surgical outcomes as well. Otosclerosis patients with low preoperative ABG, especially less than 20 dB, should be counseled and selected cautiously regarding stapes surgery.

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Section: Methodsmentioning

confidence: 99%

Stapes and Stapes Revision Surgery: Preoperative Air-Bone Gap Is a Prognostic Marker

Sharaf

Grueninger

Hilpert

et al. 2021

Otology &Amp; Neurotology

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Aktuelle Aspekte zur chirurgischen Therapie der Otosklerose

Minovi

Probst

Dazert

2009

HNO

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Otosclerosis can be of viral origin and in 25-50% of cases a familiar accumulation can be seen. Typically patients develop a progressive middle ear hearing loss which starts in young adulthood and which can affect one as well as both ears in up to 80% of cases. The surgical procedures of choice are stapedotomy and stapedectomy. Complications of surgery are persistent vertigo, secondary facial nerve palsy and the most severe complication is deafness in up to 1% of the cases. Even if the operation risks are low, the alternative use of a hearing aid must be offered in the initial consultation. A new technique of stapes surgery is laser-assisted stapedotomy. Necrosis of the incus process with dislocation of the prosthesis is the most common finding which necessitates stapes revision surgery. The aim of this article is to present the current scientific concept, diagnostics and therapy of otosclerosis with an emphasis on surgical treatment options.

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Current aspects of etiology, diagnosis and therapy of otosclerosis

Thomas

Minovi

Dazert

2011

Otolaryngologia Polska

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The presented article shows the current scientific concept including diagnostics and therapy of otosclerosis with an emphasis on surgical treatment options. The three main proposed causes for otosclerosis are viral and hormonal origin as well as a genetic predisposition. In 25 to 50% a familiar accumulation can be seen. Usually patients become aware of clinical problems by a progressive middle ear hearing loss in the young adulthood. In up to 80% of cases both ear become affected during lifetime. Surgical options of therapy are the stapedotomy, stapedectomy and the laser-assisted stapedotomy. In every case the alternative use of a hearing aid must be offered during the consultation. Typical surgical complications are rare but can be persistent vertigo, secondary facial palsy and a sensorineural hearing loss up to complete single-sided deafness in up to 1% of the cases. The most common finding which necessitates stapes revision surgery is the necrosis of the long incus process with dislocation of the stapes piston.

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Die Verlagerung des hinteren Steigbügelschenkels. Eine vergessene Methode der Otosklerosechirurgie?

Abstract: The major advantage of this technique is the avoidance of incus necrosis and foreign body reactions related to the material of the prosthesis. Disadvantages are technical plus the longer duration of the procedure.

Cited by 4 publications

References 12 publications

Stapes and Stapes Revision Surgery: Preoperative Air-Bone Gap Is a Prognostic Marker

Stapes and Stapes Revision Surgery: Preoperative Air-Bone Gap Is a Prognostic Marker

Aktuelle Aspekte zur chirurgischen Therapie der Otosklerose

Current aspects of etiology, diagnosis and therapy of otosclerosis

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