Long-term hearing results of stapedotomy: analysis of factors affecting outcome

Dhooge, Ingeborg; Desmedt, Stéphanie; Maly, Thomas; Loose, David; Hoecke, Helen Van

doi:10.1007/s00405-018-4899-2

Cited by 29 publications

(30 citation statements)

References 42 publications

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“…However, so far, there is absent of a study on direct comparison between ESS and MES for TOD, further studies employing a larger cohort and including MES are needed for validation. Moreover, we also analyzed the postoperative hearing outcomes between incus injury reconstrued by PORP implantation and stapes injury mainly reconstructed by TORP or piston implantation, no signi cant differences were found, the results were different from our previous study of ossicular chain malformation [8], the possible reason was that the piston reconstruction was also adopted for stapes injury with footplate anomaly (P4), as many studies reported, the piston prosthesis usually obtained a better hearing result [2,14,15].…”

Section: Discussionmentioning

confidence: 78%

Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

Zhang¹,

Long²,

Deng³

et al. 2020

Preprint

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Background Traumatic ossicular disruption (TOD) usually had a severe conductive hearing loss, the exploratory tympanotomy is critical for the diagnosis and improve hearing. Endoscopic ear surgery (EES) is becoming popular in the last decade, we conducted a retrospective study to explore the efficacy of EES for management of TOD and the accompanied injuries.Methods A retrospective study was performed on 18 ears (16 patients) of TOD with intact TM from May 2017 to Jun 2019 in our department. EES was conducted to check the ossicular chain anomalies, and to perform the ossiculoplasty and facial nerve (FN) decompression depending on the intraoperative findings. Hearing outcomes and surgical complications were assessed at 6 months postoperatively. Results The incus injury was the most common type of TOD, which was observed in 14 ears (77.8%), stapes suprastructure fracture was observed in 4 ears (22.2%). FN injury was found in 4 out of 13 ears with temporal bone fracture (TBF), the injury sites were mainly located in the perigeniculate area and the tympanic segment of FN. It showed the postoperative average pure-tone average (PTA) gain was 22.9 ± 9.5 dB, and the average ABG closure was 22.2 ± 8.3 dB, ABG closure to 20 dB or less and ABG closure to 10 dB or less were achieved in 18 ears (100%) and 14 ears (77.8%), respectively. The facial function achieved favorable recovery of House-Brackmann (H-B) grade Ⅰ (3 ears) and grade Ⅱ (1 ear) in all the 4 cases in 6 months after surgery. No iatrogenic FN paralysis and significant sensorineural hearing loss were observed. Conclusions ESS was effective in diagnosis and management of TOD and the accompanied otologic injuries, such as FN paralysis, it showed favorable surgical outcomes. ESS provides an alternative method to manage TOD with the advantage of excellent vision and less invasion.

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Section: Discussionmentioning

confidence: 78%

Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

Zhang¹,

Long²,

Deng³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…It is a highly successful surgery, with success rates ranging between 70 per cent and 95 per cent, and with a low rate of complications. 6,15 Many surgeons have focused on the prosthesis (piston) as an important factor in the post-operative outcomes. They have studied the effect of different prosthesis materials, shaft diameters and crimping styles.…”

Section: Discussionmentioning

confidence: 99%

“…It is a highly successful surgery, with success rates ranging between 70 per cent and 95 per cent, and with a low rate of complications. 6,15…”

Section: Discussionmentioning

confidence: 99%

Hearing results after stapedotomy for otosclerosis: comparison of prosthesis variables

et al. 2021

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Objective To evaluate the influence of different piston variables on hearing following stapedotomy. Methods Data were analysed in groups according to: piston material (titanium vs fluoroplastic), shaft diameter (0.4 mm vs 0.5 mm) and crimping style (manual crimping vs self-crimping). Pre- and post-operative average air–bone gap, air–bone gap difference, success rate and operative time were evaluated. Results and conclusion Fifty-one patients (58 ears) were included. A post-operative air–bone gap of 10 dB or lower was achieved in 44 cases, with a success rate of 75.9 per cent; 52 cases (89.7 per cent) had an air–bone gap of 20 dB or lower. The success rate was higher, but not significantly, in fluoroplastic than in titanium pistons (85 per cent vs 70 per cent). Pistons with shaft diameters of 0.5 mm and 0.4 mm had success rates of 79 per cent and 72 per cent, respectively. No significant differences were found for any audiometric parameters. There were no significant differences between manual crimping and self-crimping pistons in terms of audiometric results or success rate.

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“…Stapedotomy is the standard surgical method for restoration of hearing in patients with otosclerosis with good cochlear reserve, since it provides a successful outcome (14,15). On the other hand, there is still no consensus on the diameter of the prosthesis used for this operation.…”

Section: Discussionmentioning

confidence: 99%

Does The Diameter of The Prosthesis Affect The Outcome of Stapedotomy?

Şahin¹

2019

Erciyes Med J

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To compare the outcomes of the stapedotomies performed using Teflon prostheses with 0.4 mm and 0.6 mm diameters. Materials and Methods: Pre-and postoperative audiograms of 52 participants, who had undergone stapedotomy, were evaluated retrospectively. Participants were divided into two groups according to the diameter of the prosthesis used for their surgery: Group 1 (0.4 mm) and Group 2 (0.6 mm). Air conduction (AC) pure tone thresholds at 250, 500, 1000, 2000, 4000, and 6000 Hz and air-bone gaps (ABGs) at 500, 1000, 2000, and 4000 Hz, as well as pure tone averages (PTAs), were compared within and between groups. Results: Hearing gain, with regard to AC thresholds and ABGs, was statistically significant within both groups for each frequency (p<0.05). Pre-and postoperative PTAs and ABGs were similar between the groups (p>0.05). Whereas the preoperative AC thresholds were similar between the groups at all frequencies, postoperative AC thresholds of the 0.6 mm group were better than those of the 0.4 mm group at 2000 Hz (p<0.05). However, postoperative AC thresholds were similar between the groups at all frequencies other than 2000 Hz (p>0.05). Conclusion: The outcomes of the stapedotomies with 0.4 and 0.6 mm Teflon prostheses were similar to each other with regard to postoperative hearing gain, PTA, and ABG. However, only at 2000 Hz, AC thresholds were found to be better in patients with a 0.6 mm prosthesis than in those with a 0.4 mm prosthesis.

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Long-term hearing results of stapedotomy: analysis of factors affecting outcome

Abstract: Our series confirms excellent hearing results achieved in stapedotomy surgery, also in long-term follow-up. On the long-term no patient-, disease-, or procedure-related variables were identified as predictors of surgical success.

Cited by 29 publications

References 42 publications

Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

Hearing results after stapedotomy for otosclerosis: comparison of prosthesis variables

Does The Diameter of The Prosthesis Affect The Outcome of Stapedotomy?

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