Abstract:The Causse technique of performing stapedotomy with vein graft interposition is widely-employed, with the vein graft harvested from the dorsum of the hand/wrist. Donor site scarring may be of cosmetic concern, especially in female patients. A prospective series of 19 patients undergoing stapedotomy with vein graft harvested from the superficial temporal vein is evaluated from aesthetic and functional perspectives. Results show that vein interposition from this donor site is not only aesthically acceptable but … Show more
“…A long-term prospective audiometric evaluation study by Vincent et al, [ 36 ] demonstrated the stability of the results with vein graft over time. The vein is traditionally harvested from the wrist or dorsum of the hand; alternatively, the superficial temporal vein or its branches can be used, with the added advantages of better cosmetic outcome and working on the same operative site [ 37 ]. Like the superficial temporal vein, the tragal or conchal perichondrium has the advantage to be accessible in the same operative field, although there is some concern for the chondrogenic potential of this graft, which can probably be avoided by orienting it properly and not traumatizing it [ 38 ].…”
Objective
To compare the efficacy and safety characteristics of different materials used for oval window sealing during stapedotomy.
Methods
A systematic review was conducted according to the PRISMA guidelines. Published international English literature from January 1, 2000 to December 2021 was screened, checking for studies that compared different materials utilization in patients undergoing stapedotomy surgery for otosclerosis or congenital stapes fixation. Data related to the efficacy and safety of each material were extracted. The primary outcome measure was the air–bone gap (ABG) closure after surgical intervention.
Results
Six studies were included in the metanalysis. Because of the heterogeneity of the treatments adopted, we assessed the use of the fat compared to all other treatments, and the use of the gelfoam compared to all other treatments. In the former analysis (fat vs others) we did not identify differences in ABG closure between the groups (p = 0.74), with a low heterogeneity of the results (I2 = 28.36%; Hedge’s g = 0.04, 95% CI − 0.19 0.27); similarly, we did not identify differences between the use of gelfoam and other treatments (p = 0.97), with a low heterogeneity of the results (I2 = 28.91%; Hedge’s g = 0.00, 95% CI − 0.20 0.21).
Conclusions
Numerous options are available for oval window sealing during stapedotomy, with acceptable safety and effectiveness profiles. Based on the current data, no definitive recommendation can be made regarding the choice of one material over another, and the convenience of sealing over no sealing at all.
“…A long-term prospective audiometric evaluation study by Vincent et al, [ 36 ] demonstrated the stability of the results with vein graft over time. The vein is traditionally harvested from the wrist or dorsum of the hand; alternatively, the superficial temporal vein or its branches can be used, with the added advantages of better cosmetic outcome and working on the same operative site [ 37 ]. Like the superficial temporal vein, the tragal or conchal perichondrium has the advantage to be accessible in the same operative field, although there is some concern for the chondrogenic potential of this graft, which can probably be avoided by orienting it properly and not traumatizing it [ 38 ].…”
Objective
To compare the efficacy and safety characteristics of different materials used for oval window sealing during stapedotomy.
Methods
A systematic review was conducted according to the PRISMA guidelines. Published international English literature from January 1, 2000 to December 2021 was screened, checking for studies that compared different materials utilization in patients undergoing stapedotomy surgery for otosclerosis or congenital stapes fixation. Data related to the efficacy and safety of each material were extracted. The primary outcome measure was the air–bone gap (ABG) closure after surgical intervention.
Results
Six studies were included in the metanalysis. Because of the heterogeneity of the treatments adopted, we assessed the use of the fat compared to all other treatments, and the use of the gelfoam compared to all other treatments. In the former analysis (fat vs others) we did not identify differences in ABG closure between the groups (p = 0.74), with a low heterogeneity of the results (I2 = 28.36%; Hedge’s g = 0.04, 95% CI − 0.19 0.27); similarly, we did not identify differences between the use of gelfoam and other treatments (p = 0.97), with a low heterogeneity of the results (I2 = 28.91%; Hedge’s g = 0.00, 95% CI − 0.20 0.21).
Conclusions
Numerous options are available for oval window sealing during stapedotomy, with acceptable safety and effectiveness profiles. Based on the current data, no definitive recommendation can be made regarding the choice of one material over another, and the convenience of sealing over no sealing at all.
“…In those papers that reported the ABG closure correctly, only 11.8 per cent reported the mean, SD and range of their results 6 , 19 , 22 , 29 , 42 , 44 , 51 . A one-year follow-up audiogram was conducted in only 60.1 per cent of studies 7 , 14 – 16 , 19 , 21 , 23 , 25 , 27 , 29 – 31 , 33 , 36 – 39 , 41 – 45 , 47 , 50 , 51 , 55 , 57 , 59 – 61 Non-adherence to current guidelines can lead to over-inflated reports of successful air–bone gap closureThis can affect the consent process and patient expectationsClear guidelines exist for reporting otological surgery outcomesNevertheless, incorrect reporting continues and minimal datasets are still missingAdherence to guidelines provides accurate outcomes and inter-study comparisons…”
Despite the existence of clear guidelines, stapes surgery outcomes are still being over-reported as successful. This can lead to incorrect information being provided to patients during the consent process and makes comparative studies difficult.
“…The tympanomeatal flap was finally repositioned after performing the bend and lift test. 12,13 Figure 2.(a) Vein graft surround diagram showing the piston placed in the oval window (OW) fenestra surrounded by vein graft. (b) Microscopic image of vein graft surround technique.…”
Section: Methodsmentioning
confidence: 99%
“…The tympanomeatal flap was finally repositioned after performing the bend and lift test. 12,13 Audiological assessment Air-bone gap (ABG), air conduction and bone conduction thresholds were measured pre-operatively and postoperatively. A 4-frequency pure tone average value was calculated for air conduction and bone conduction thresholds at 500, 1000, 2000 and 4000 Hz obtained pre-and postoperatively.…”
Objective
This study evaluated audiological outcomes of stapedotomy using two different techniques, vein graft interposition and vein graft surround, for sealing the stapes fenestra.
Method
A retrospective study of 130 patients who underwent stapedotomy for otosclerosis was performed. A total of 84 patients underwent the vein graft surround procedure and 46 underwent the vein graft interposition procedure. Post-operative hearing outcome was compared between them.
Results
A total of 55 of 130 patients had a post-operative air–bone gap of less than 10 dB. A total of 57 patients had an air–bone gap within 20 dB. The average air–bone gap was 13.16 dB at 3 months with a mean improvement of 22.06 dB (11.98 dB for vein graft interposition and 13.80 dB for vein graft surround; p = 0.79).
Conclusion
There was no significant difference in hearing outcome between the two techniques. The vein graft interposition technique is preferred for large fenestra or stapedectomy cases and in cerebrospinal fluid gusher cases. The vein graft surround technique is easier to perform and preferred in small fenestra stapedotomy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
