Humans ; Otosclerosis/surgery* ; Stapes ; Stapes Surgery/adverse effects* ; Arteries

Humans ; Stapes ; Otosclerosis/surgery* ; Ossicular Prosthesis ; Stapes Surgery ; Incus

BACKGROUND AND OBJECTIVES: A free-beam-type CO₂ laser, which use a micromanipulator mounted on a microscope as the delivery system, has the merit of not being affected by hand tremor at the time of shooting. However, this delivery system has several disadvantages, including a restricted operation range and a risk of incorrect focusing. A fiber-type CO₂ laser uses a hand-held delivery system and has the opposite merits and demerits. We compared the results of stapes surgery with free-beam and fiber type delivery systems. SUBJECTS AND METHODS: The study enrolled 36 patients who underwent stapedotomy with free-beam- (n=26) or fiber- (n=10) type CO₂ lasers. The air-bone (AB) gap closure, bone conduction (BC) change, and operating time were evaluated. The AB gap closure was calculated by subtracting the preoperative BC thresholds from the postoperative air conduction thresholds. The BC change was calculated by subtracting the postoperative BC thresholds from the preoperative BC thresholds. RESULTS: The mean operating time was significantly (p=0.035) shorter in the fiber-type group (72.5±8.2 min) than in the free-beam-type group (80.5±11.4 min). The mean AB gap closure did not differ significantly (p=0.297) between the free-beamand fiber-type groups (5.8±10.1 and 1.4±6.8 dB, respectively). The mean BC change did not differ significantly (p=0.873) between the free-beam- and fiber-type groups (2.4±6.9 and 2.8±5.3 dB, respectively). The hearing outcomes did not differ significantly between the two groups. CONCLUSIONS: Operating times were significantly shorter using the fiber-type CO₂ laser, while hearing outcomes did not differ significantly between the two groups.
Bone Conduction ; Hand ; Hearing ; Humans ; Otosclerosis ; Stapes Surgery* ; Stapes* ; Tremor

Adult ; Female ; Humans ; Male ; Middle Aged ; Otosclerosis ; surgery ; Stapes Surgery ; methods

OBJECTIVE: To evaluate the feasibility, safety and effectiveness of malleostapedotomy based on malleus-oval window technique in otosclerosis with malleus/incus mobility disorder. METHOD: Six cases with malleostapedotomy on stapes footplate fixation accompanied by malleus/incus movements disorder from March 2005 to March 2007 were analyzed retrospectively, when totally 78 cases of conventional stapes surgeries were performed on isolated otosclerosis . The surgical procedures, intraoperative findings and postoperative vertigo as well as pure tone gain were discussed. RESULT: All of the 6 cases showed stapes footplate fixation. Both abnormal incudomalleolar joint and incudostapedial joint were found in 2 cases. It was suspected that previous inflammation resulted in yellowish mucosa, ossicular malformation and stiffness. The third one showed local tympanosclerosis in the attic. In another 2 cases, idiopathic malleus head fixation related to the anterior and superior mallear ligament abnormal were presented while a surgical incudomalleolar joint dislocation prior to the observation happened in the last one. Among these 6 cases, there was no 4.0 Hz notch and postoperative vertigo which needs a further care. Postoperative air-bone gap on 0.5 kHz, 1.0 kHz, 2.0 kHz, 4.0 kHz averaged less than 10 dB. All the patients had been followed up for 3 months. CONCLUSION Malleostapedotomy based on malleus-oval window technique is a safe and effective procedure available for otosclerosis with malleus/incus movement disorder from different origins.
Adult ; Female ; Humans ; Incus ; surgery ; Male ; Malleus ; surgery ; Middle Aged ; Otosclerosis ; surgery ; Retrospective Studies ; Stapes Surgery ; methods ; Treatment Outcome

Otosclerosis is known to be rare in orientals, but there have been a few reports of the clinically suspicious otosclerosis cases in Korea. Otosclerosis is a bony disorder involving endochondral bone of the otic and labyrinthine capsule. Advanced and very advanced otosclerosis are conditions in which the otosclerotic involvement of the otic capsule has progressed to result in profound deafness with undetectable bone and air conduction thresholds. The patients, who have severe to profound hearing loss due to otosclerosis, potentially benefit from a stapes surgery and optimal hearing aid fitting. But there are a few reports that cochlear implantation may provide these patients with a superior outcome. We report a 58 year-old man with severe to profound hearing loss, which was a first reported case of cochlear implantation employed to treat otosclerosis in Korea. We present this with a review of the related literature.
Cochlear Implantation* ; Cochlear Implants* ; Deafness ; Hearing Aids ; Hearing Loss ; Humans ; Korea ; Middle Aged ; Otosclerosis* ; Stapes Surgery

Postoperative vertigo can occur after stapes surgery in approximately 5% of the patients, which more commonly presents immediately after surgery rather than in the delayed period. Isolated delayed vertigo after stapes surgery is commonly related to perilymphatic fistula. Herein we report a 36-year-old female patient who developed positional vertigo 18 days after stapes surgery demonstrating severe geotropic horizontal positional nystagmus on both sides during supine roll test. This patient was eventually diagnosed as the horizontal semicircular canal benign paroxysmal positional vertigo (BPPV) on the left side. This is a rare case of delayed vertigo following stapes surgery caused by BPPV rather than perilymphatic fistula.
Adult ; Female ; Fistula ; Humans ; Nystagmus, Physiologic ; Otosclerosis ; Semicircular Canals ; Stapes Surgery ; Stapes ; Vertigo

OBJECTIVETo assess the effect of stapes surgery on advanced otosclerosis (AO).

METHODSIn 300 cases randomly collected of otosclerosis in 1970 to 1999, 68 cases (77ears) were selected for retrospective analysis, which met the criteria of advanced otosclerosis (mixed deafness, with bone-conduction levels exceeding 40 dB and air-conduction levels exceeding 70 dB in 500 - 2000 Hz).

RESULTSThe air-conduction of sixty-eight cases (77 ears) were from 77.32 dB to 53.7 dB (500-2000 Hz) after operation, mean decreased 23.62 dB. Of 71 ears (92.21%) obtained air-conduction improved over 10 dB, of 46 ears (59.74%) gained A-B Gap closure in 10 dB. Air-conduction were from 79.01 dB to 58.23 dB (500 - 4000 Hz) after operation and mean decreased 20.78 dB. Of 68 ears (88.31%) obtained air-conduction improved over 10 dB, of 32 ears (41.56%) gained A-B gap closure in 10 dB. After followed up 5-25 years, of 67 ears were retained stabilization, of 28 ears obtained more improve than postoperation. But 4 ears had drop (all was stapes-elevation and re-improvement after them was reviewed).

CONCLUSIONStapes surgery is effective operation to cured otosclerosis, advanced otosclerosis or far-advanced otosclerosis had greater help to improved hearing.

Adult ; Aged ; Ear Diseases ; surgery ; Female ; Humans ; Male ; Middle Aged ; Otosclerosis ; surgery ; Retrospective Studies ; Stapes Surgery ; methods ; Treatment Outcome

OBJECTIVE: To investigate the feasibility of the treatment of otosclerosis using laser stapedotomy with mini incision in the external auditory meatus. METHOD: Thirteen patients(15 ears) with otosclerosis evidence on clinic history. They were all operated using the laser assisted stapedotomy by mini incision in external auditory meatus because of the wide straight canal. Laser resection the tendo musculistapedius and anterior and postrior arch, breaking the articulatioincudostapedia, removing the stapes superstructure, making a hole of 6mm diameter in the rear of stapes footplate by laser drilling, implanting the corresponding length Piston artificial ossicle. RESULT: All the surgeries were successful and the operation time was about one hour. There was only one patient manifested vertigo and nausea after the operation. But the symptoms improved three days later after the expectant treatment. All the incisions were healed in the externals. There was significant difference between the preoperative and postoperative PTA. The air conduct improved in every frequent and the bone conduct improved in 1 kHz, 2 kHz and 4 kHz. CONCLUSION Laser assisted stapedotomy by mini incision in the external auditory meatus in patients having wide straight canal with otosclerosis can shorten the operation time, minimize the tissue damage, fasten the healing of the incision and reduce the complications postoperatively. In addition, the mini incision is beauty and easy to nurse.
Ear Canal ; surgery ; Humans ; Lasers ; Otosclerosis ; surgery ; Postoperative Complications ; Postoperative Period ; Prostheses and Implants ; Stapes ; Stapes Surgery ; Treatment Outcome

BACKGROUND AND OBJECTIVES: Hearing loss is the main symptom of otosclerosis. Stapes surgery could restore the hearing ability, but the amount of restoration was changed as time passed. The aims of this study were to analyze the outcome of primary stapes surgery in otosclerosis and to compare hearing changes in stapedectomy and stapedotomy group. SUBJECTS AND METHOD: This study involved 221 ears, which were operated on for otosclerosis in Seoul National University Hospital from 1983 to 2005. We analyzed the hearing results of stapes surgery regarding air conduction, bone conduction, air-bone gap using the operation methods in preoperative, postoperative 1, 3, 6, 12, 24 months and after 36-months period. RESULTS: Stapedectomy was performed in 75 ears and stapedotomy in 146 ears. There were no differences of mean age, preoperative hearing between stapedectomy and stapedotomy group. In the postoperative period, hearing thresholds were significantly decreased compared with preoperative period in each group. The stapedectomy group showed more improvement of air conduction and reduction of AB gap than the stapedotomy group. Results of bone conduction showed no difference after the postoperative 12 months period between the two groups. Hearing improvement went on upto postoperative 12 months. Development of sensorineural hearing loss was found in two patients (2.7%) in the stapedectomy group and in one patient (0.68%) in the stapedotomy group. CONCLUSION: Stapedectomy showed better hearing results, but had more risks of sensorineural hearing loss in this study.
Bone Conduction ; Ear ; Hearing ; Hearing Loss ; Hearing Loss, Sensorineural ; Humans ; Otosclerosis ; Postoperative Period ; Preoperative Period ; Stapes ; Stapes Surgery