Malleostapedotomy in Revision Surgery for Otosclerosis

Fisch, Ugo; Acar, Gül Özbilen; Huber, Alexander

doi:10.1097/00129492-200111000-00011

Cited by 94 publications

(106 citation statements)

References 7 publications

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“…The presence of fi brous adhesions was found in 12 patients (27.9 %) This result is compared to literature where the incidence of fi brosis is published to range from 2 to 38 % (10,14).…”

Section: Discussionmentioning

confidence: 57%

Revision operations after previous stapes surgery for persisting hearing loss

Skrivan¹,

Čada²,

Kluh³

et al. 2014

BLL

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Abstract:Objectives: The aim of the study was to fi nd out the reasons of the recurrent or persisting hearing loss after previous stapes surgery indicated for otosclerosis. Background: Revision stapes surgery is a relatively safe surgical method. Recurrent or persisting conductive hearing loss is commonly caused by prosthesis dislocation and adhesions in the oval window. Hearing loss is directly proportional to the number of previous operations. Method: Retrospective analysis of 48 patients after revision stapes surgery was done over a period of 4 years (2005)(2006)(2007)(2008). Improvement of the hearing and the reasons of a previous surgery failure were studied. Results: Results were compared to the other studies. The main reason of the failed surgery was adhesions and dislocation of the prosthesis. The mean postoperative air-bone gap was 12.0 dB. A mean postoperative air-bone gap closure within 10 dB occurred in 24 cases (55.8 %), between 11-20 dB occurred in 11 cases (25.6 %) and above 20 dB in 8 cases (18.6 %). The original prosthesis was replaced with a new one in 41 (95.3 %) cases. In 2 cases (4.7 %), previous prostheses were left in place and fi xed by a ionomer glass cement to the long process of incus. Conclusion: Revision stapes surgery is a relatively safe surgical procedure allowing to improve hearing. The number of previous stapes surgery deteriorates hearing (p < 0.05) (Tab. 4, Ref. 20). Text in PDF www.elis.sk.

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“…The presence of fi brous adhesions was found in 12 patients (27.9 %) This result is compared to literature where the incidence of fi brosis is published to range from 2 to 38 % (10,14).…”

Section: Discussionmentioning

confidence: 57%

Revision operations after previous stapes surgery for persisting hearing loss

Skrivan¹,

Čada²,

Kluh³

et al. 2014

BLL

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“…The best results were observed at the lower frequencies of 0.5-1 kHz, while worse ABGs and bone conduction results were found at 4 kHz. Fisch et al 4 found a significantly better functional result for malleostapedotomy, compared with standard incus-stapedotomy, at 0.5 and 1 kHz. 4 • Use of a modified malleostapedotomy in primary and revision surgery was assessed • An enlarged skin flap incision and a partial anterosuperior canalplasty allowed better malleus exposure and access • This technique should be used for malleus or incus pathology combined with footplate fixation • Results are equivalent to or better than standard incus-stapedotomy…”

Section: Discussionmentioning

confidence: 99%

“…However, following the introduction of three major improvements by Fisch, May and colleagues, 3,4 the technique (termed malleostapedotomy by Fisch) was revived. These improvements were as follows.…”

Section: Introductionmentioning

confidence: 99%

From incus bypass to malleostapedotomy: technical improvements and results

2012

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Objective: To assess results of malleostapedotomy using a Fisch Storz titanium piston with at least 10 months' follow up.Methods: Using a prospective database, the indications, surgical technique, and pre-and post-operative audiometric data for 60 patients undergoing malleostapedotomy between 2002 and 2010 were evaluated. Diagnoses and primary and revision surgeries were compared with reference to the literature.Results: Sixty endaural malleostapedotomies were performed, 28 as a primary intervention and 32 as revision surgery. In 68 per cent, the underlying pathology was otosclerosis. The most common reason for revision surgery (i.e. in 59 per cent) was prosthesis dysfunction. Overall, the mean air-bone gap (0.5-3 kHz) for the primary intervention and revision surgery groups was 9.4 and 11.3 dB, respectively; an air-bone gap of less than 20 dB was obtained in 100 and 81 per cent of patients, respectively. There was no significant audiological difference between the primary and revision surgeries groups, and no deafness.Conclusion: Malleostapedotomy shows comparable results to standard incus-stapedotomy and may be preferable in the presented situations.

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“…Results of ABG closure are less satisfactory than those of primary surgery [10] . Various surgical techniques have been described such as bypassing the LPI necrosis with TORP, malleovestibular prosthesis [11] , or recent use of reconstruction of LPI with bone cement, which allows the reconstruction of the natural incus-oval window interface [5] . This study aimed to discuss the different modalities for managing LPI necrosis in revision stapedectomy on the basis of the degree of necrosis and to perform a literature review.…”

Section: Introductionmentioning

confidence: 99%

Revision Stapedectomy with Necrosis of the Long Process of the Incus: Does the Degree of Necrosis Matter? A Retrospective Clinical Study

Ghonim

Shabana²,

Ashraf³

et al. 2017

Int Adv Otol

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OBJECTIVE:To discuss the different modalities for managing necrosis of the long process of the incus in revision stapedectomy on the basis of the degree of necrosis and compare the results with those reported in the literature. MATERIALS and METHODS:Thirty-six patients underwent revision stapedectomy with the necrosis of the long process of the incus from 2009 to 2016. The patients were divided into three groups on the basis of the degree of necrosis. For group A (minimal necrosis), augmentation technique with bone cement was performed. For group B (partial necrosis), the cement plug technique was performed. For group C (sever necrosis), malleus relocation with malleovestibulopexy was performed using reshaped necrosed incus. Air and bone conduction thresholds at frequencies of 500-3000 Hz were reviewed pre-and postoperatively using conventional audiometry. The air-bone gap (ABG) and bone conduction thresholds were measured. RESULTS:Postoperative ABG was reduced to <10 dB in 28 cases (77.8%) and <20 dB in all cases (100%). There was no significant change in postoperative bone conduction thresholds. The mean patient follow-up duration was 23 (range, 18-36) months. The cement plug technique was used in 75% of cases. CONCLUSION:Managing necrosis of the long process of the incus in revision stapedectomy should be considered according to the degree of necrosis. The cement plug technique is considered to be a reasonable option in most cases. Malleus relocation with malleovestibulopexy is an effective alternative to prosthesis.

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Malleostapedotomy in Revision Surgery for Otosclerosis

Cited by 94 publications

References 7 publications

Revision operations after previous stapes surgery for persisting hearing loss

Revision operations after previous stapes surgery for persisting hearing loss

From incus bypass to malleostapedotomy: technical improvements and results

Revision Stapedectomy with Necrosis of the Long Process of the Incus: Does the Degree of Necrosis Matter? A Retrospective Clinical Study

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