Does it make sense to preserve the stapedial muscle during surgical treatment for otosclerosis?

Abstract

Our study aimed to show whether it is useful to preserve the stapedial muscle during the surgical treatment of otosclerosis. The study was carried out on 67 patients with tympanoscopic evidence of otosclerosis. In group A (34 patients) the stapedial muscle was intra-operatively preserved as follows: the stapedial suprastructure with preserved muscle tendon was transpositioned onto the longer arm of the incus and secured with a wire loop. The mean uncomfortable level for sounds was measured after surgery and the results of group A patients were compared with those obtained in group B (33 patients, who underwent standard surgery). One month after surgery, in group A patients, the cochleostapedial reflex was evoked in 21 patients (61.8 per cent) and two months later in 32 patients (94.1 per cent). One month after operation, in group A patients the mean uncomfortable level was 108.8 dB, while three months later it increased to 114.1 dB. In group B, the relevant values were 97.8 dB one month after surgery, and 98.0 dB three months later. Our presumption that stapedial muscle preservation is necessary has been proved by the fact that the patients with the preserved muscle had a higher noise discomfort threshold.

Comparison of Uncomfortable Loudness Level in Stapedotomy with or without Stapedial Tendon Preservation

“…This finding of stapedial tendon preservation stapedotomy was statistically significant which was quite similar to finding of Silverstain et al 10 Gross et al 14 and Rasmy et al 20 .…”

“…Audiometric test showed similar type of hearing outcome whether the tendon is preserved or not 12 . In the recent years, stapedial tendon preservation surgery has been advocated by some surgeons in hopes of obtaining better functional outcomes 11,14 .…”

The Effect of Alprazolam on Acoustic Stapedius Reflex Thresholds in Healthy Volunteers

“…There are a limited number of studies regarding how antidepressant and anxiolytic agents affect the reactions of the organism to light, sound, and tactile stimuli [1][2][3][4][5][6]. On the other hand, in the literature review, no studies regarding the effects of these drugs on the ASR were encountered.…”

Middle ear microvascularization: an “in vivo” endoscopic anatomical study

“…In fact, it has been widely debated about a possible ST preservation during this procedure to prevent the devascularization and necrosis of the LPI. Although many authors have reported excellent objective and subjective results in patients who underwent to stapedectomy or stapedotomy with ST preservation, its usefulness is still controversial [13][14][15][16][17][18][19]. In addition, according to our findings, the BFD of the stapedial vessels seems to have an opposite direction to the LPI.…”